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v1.0.0
ICD-10 Guide
ICD-10 CodesO35.8

O35.8

Billable

Maternal care for other (suspected) fetal abnormality and damage

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

Code Description

ICD-10 O35.8 is a billable code used to indicate a diagnosis of maternal care for other (suspected) fetal abnormality and damage.

Key Diagnostic Point:

O35.8 is used to indicate maternal care for suspected fetal abnormalities that are not classified under other specific codes. This may include conditions such as suspected congenital anomalies, genetic disorders, or other fetal damage that may not yet be definitively diagnosed. Prenatal care often involves various diagnostic tests, including ultrasounds, amniocentesis, and genetic counseling, to assess fetal health and development. Maternal care in these cases is crucial as it allows for early intervention, planning for delivery, and potential treatment options for the newborn. The management of these cases requires a multidisciplinary approach, involving obstetricians, maternal-fetal medicine specialists, genetic counselors, and pediatricians to ensure comprehensive care for both the mother and the fetus.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation requirements across different healthcare providers.
  • Need for precise clinical details to support the diagnosis of suspected abnormalities.
  • Potential overlap with other codes for fetal conditions, leading to confusion.
  • Requirement for thorough understanding of genetic conditions and their implications.

Audit Risk Factors

  • Inadequate documentation of the suspected condition.
  • Failure to include relevant prenatal diagnostic test results.
  • Misuse of the code due to lack of specificity.
  • Inconsistent coding practices among different providers.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed prenatal visit notes, including ultrasound findings, genetic counseling notes, and maternal health assessments.

Common Clinical Scenarios

Routine prenatal visits where fetal abnormalities are suspected based on ultrasound findings or maternal history.

Billing Considerations

Ensure that all suspected conditions are documented clearly, and that any referrals to specialists are noted.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive records of high-risk assessments, genetic testing results, and multidisciplinary care plans.

Common Clinical Scenarios

Management of pregnancies with known or suspected fetal abnormalities requiring specialized care.

Billing Considerations

Focus on the integration of genetic counseling and advanced imaging results in documentation.

Coding Guidelines

Inclusion Criteria

Use O35.8 When
  • Coders should follow the official ICD
  • CM guidelines for obstetric coding, ensuring that the documentation supports the diagnosis of suspected fetal abnormalities
  • It is essential to use additional codes to specify any related conditions or complications

Exclusion Criteria

Do NOT use O35.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76801CPT Code

Ultrasound, pregnant uterus, transabdominal, real-time with image documentation

Clinical Scenario

Used during routine prenatal visits when fetal abnormalities are suspected.

Documentation Requirements

Document findings from the ultrasound and any follow-up actions taken.

Specialty Considerations

Ensure that the ultrasound report is detailed and correlates with the suspected diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specificity in coding suspected fetal abnormalities, improving the accuracy of maternal care documentation and facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specificity in coding suspected fetal abnormalities, improving the accuracy of maternal care documentation and facilitating better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specificity in coding suspected fetal abnormalities, improving the accuracy of maternal care documentation and facilitating better patient management.

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

When should O35.8 be used?

O35.8 should be used when there is a suspicion of a fetal abnormality based on clinical findings, but a definitive diagnosis has not yet been established. It is important to document all relevant findings and any follow-up actions taken.