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v1.0.0
ICD-10 Guide
ICD-10 CodesO35.15

O35.15

Billable

Maternal care for (suspected) chromosomal abnormality in fetus, sex chromosome abnormality

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/08/2025

Code Description

ICD-10 O35.15 is a billable code used to indicate a diagnosis of maternal care for (suspected) chromosomal abnormality in fetus, sex chromosome abnormality.

Key Diagnostic Point:

O35.15 is used to indicate maternal care for a fetus suspected of having a chromosomal abnormality, specifically a sex chromosome abnormality. This code is relevant in cases where prenatal screening or diagnostic tests suggest the possibility of conditions such as Turner syndrome, Klinefelter syndrome, or other sex chromosome aneuploidies. Maternal care involves comprehensive monitoring and management strategies to address potential complications associated with these abnormalities. This may include genetic counseling, additional imaging studies, and discussions regarding the implications of the diagnosis for both the mother and the fetus. The healthcare provider must document the rationale for the suspicion of chromosomal abnormalities, the tests performed, and any referrals made for further evaluation. Proper coding ensures that the healthcare team can provide appropriate care and that the mother receives the necessary support throughout her pregnancy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for accurate interpretation of genetic testing results
  • Variability in clinical presentation of chromosomal abnormalities
  • Requirement for multidisciplinary collaboration (genetics, obstetrics, pediatrics)
  • Potential for evolving clinical guidelines based on new research

Audit Risk Factors

  • Inadequate documentation of genetic counseling sessions
  • Failure to document the rationale for testing
  • Misinterpretation of test results leading to incorrect coding
  • Lack of follow-up documentation on fetal outcomes

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include details of prenatal screenings, genetic counseling sessions, and any referrals made for further evaluation.

Common Clinical Scenarios

Common scenarios include abnormal ultrasound findings, positive non-invasive prenatal testing (NIPT) results, and maternal concerns regarding genetic conditions.

Billing Considerations

Special considerations include ensuring that all discussions regarding the implications of findings are documented and that the patient understands the potential outcomes.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancy documentation must include detailed assessments of fetal growth, development, and any interventions planned based on genetic findings.

Common Clinical Scenarios

Complex maternal-fetal scenarios may involve multiple consultations with geneticists and additional imaging studies to monitor fetal development.

Billing Considerations

Considerations for high-risk obstetric coding include the need for ongoing monitoring and the potential for additional interventions based on evolving clinical findings.

Coding Guidelines

Inclusion Criteria

Use O35.15 When
  • According to official coding guidelines, O35
  • 15 should be used when there is a suspicion of a chromosomal abnormality based on prenatal testing
  • Coders must ensure that documentation supports the diagnosis and that all relevant tests and consultations are recorded

Exclusion Criteria

Do NOT use O35.15 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76817CPT Code

Ultrasound, fetal, transabdominal, real-time with image documentation

Clinical Scenario

Used for monitoring fetal development in cases of suspected chromosomal abnormalities.

Documentation Requirements

Documentation must include indications for the ultrasound and findings related to fetal growth and development.

Specialty Considerations

Obstetricians should ensure that all findings are communicated to the patient and documented in the medical record.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of maternal care related to fetal abnormalities, improving the accuracy of diagnoses and the ability to track outcomes associated with chromosomal abnormalities.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of maternal care related to fetal abnormalities, improving the accuracy of diagnoses and the ability to track outcomes associated with chromosomal abnormalities.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What should be documented when using code O35.15?

Documentation should include the reason for suspicion of a chromosomal abnormality, results of any genetic testing, details of genetic counseling provided, and any follow-up plans for monitoring the pregnancy.