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v1.0.0
ICD-10 Guide
ICD-10 CodesO35.7

O35.7

Billable

Maternal care for (suspected) damage to fetus by other medical procedures

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

Code Description

ICD-10 O35.7 is a billable code used to indicate a diagnosis of maternal care for (suspected) damage to fetus by other medical procedures.

Key Diagnostic Point:

O35.7 is used to indicate maternal care for a fetus that is suspected to have been damaged by medical procedures performed during pregnancy. This code encompasses a range of scenarios where fetal abnormalities or genetic conditions may arise due to interventions such as invasive prenatal testing (e.g., amniocentesis, chorionic villus sampling), surgeries, or other medical procedures. The documentation must reflect the specific procedure and its potential impact on fetal health. Clinicians must provide thorough assessments and follow-up care to monitor fetal development and address any abnormalities that may be identified. This code is crucial for ensuring that appropriate care is provided and that any potential risks associated with medical interventions are documented and managed effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of medical procedures that can lead to fetal damage
  • Need for detailed documentation of procedures and outcomes
  • Differentiation between suspected and confirmed damage
  • Potential for overlapping codes with other obstetric conditions

Audit Risk Factors

  • Inadequate documentation of the medical procedure performed
  • Failure to specify the suspected nature of fetal damage
  • Misuse of related codes that do not accurately reflect the situation
  • Lack of follow-up documentation on fetal health

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include details of the medical procedure, any fetal monitoring results, and follow-up care plans.

Common Clinical Scenarios

Scenarios may include amniocentesis leading to suspected fetal distress or complications arising from maternal surgeries.

Billing Considerations

Coders should ensure that all relevant procedures are documented and that the potential impact on the fetus is clearly articulated.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancy documentation must include comprehensive assessments of fetal health and any interventions performed.

Common Clinical Scenarios

Complex cases may involve multiple procedures, such as fetal surgery or advanced imaging techniques, with potential implications for fetal health.

Billing Considerations

High-risk scenarios require meticulous documentation to support coding and justify the medical necessity of interventions.

Coding Guidelines

Inclusion Criteria

Use O35.7 When
  • According to official coding guidelines, O35
  • 7 should be used when there is a clear indication of suspected fetal damage due to medical procedures
  • Coders must ensure that the documentation supports the use of this code and that all relevant details are captured

Exclusion Criteria

Do NOT use O35.7 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59000CPT Code

Amniocentesis

Clinical Scenario

Used for prenatal diagnosis of genetic conditions, which may lead to suspected fetal damage.

Documentation Requirements

Documentation must include indications for the procedure and any complications noted.

Specialty Considerations

Obstetricians must ensure that informed consent is obtained and documented.

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 suspected fetal damage, improving the granularity of data and enhancing the ability to track outcomes and complications.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of maternal care related to suspected fetal damage, improving the granularity of data and enhancing the ability to track outcomes and complications.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of maternal care related to suspected fetal damage, improving the granularity of data and enhancing the ability to track outcomes and complications.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What types of procedures might lead to the use of O35.7?

Procedures such as amniocentesis, chorionic villus sampling, or any surgical interventions during pregnancy that raise concerns about potential fetal damage may warrant the use of O35.7.