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v1.0.0
ICD-10 Guide
ICD-10 CodesO36.0112

O36.0112

Billable

Maternal care for anti-D [Rh] antibodies, first trimester (fetus 2)

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

Code Description

ICD-10 O36.0112 is a billable code used to indicate a diagnosis of maternal care for anti-d [rh] antibodies, first trimester (fetus 2).

Key Diagnostic Point:

O36.0112 refers to maternal care for a pregnancy complicated by the presence of anti-D (Rh) antibodies during the first trimester, specifically for the second fetus in a multiple gestation. This condition arises when an Rh-negative mother carries an Rh-positive fetus, leading to the potential for hemolytic disease of the newborn (HDN) if not properly managed. The presence of these antibodies can cause fetal complications such as intrauterine growth restriction (IUGR), fetal distress, and even fetal demise if the condition is severe and left untreated. Close monitoring through ultrasound and serological testing is essential to assess fetal well-being and growth. Maternal care may include Rh immunoglobulin administration to prevent sensitization, as well as regular follow-ups to monitor the fetus's health and development. The management of this condition requires a multidisciplinary approach, often involving obstetricians and maternal-fetal medicine specialists to ensure optimal outcomes for both mother and fetus.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of immunology related to Rh incompatibility.
  • Involves monitoring multiple fetuses and their individual health statuses.
  • Documentation must reflect the specific trimester and fetal number.
  • Potential for complications necessitates detailed clinical follow-up.

Audit Risk Factors

  • Inadequate documentation of maternal antibody status.
  • Failure to document fetal monitoring results.
  • Misclassification of the trimester or fetal number.
  • Lack of clarity in the treatment plan for Rh immunoglobulin administration.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of maternal blood tests, ultrasound findings, and treatment plans are essential.

Common Clinical Scenarios

Management of Rh-negative mothers with Rh-positive fetuses, monitoring for signs of fetal distress or growth restriction.

Billing Considerations

Accurate coding requires understanding of the implications of Rh incompatibility and its management.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including maternal history and fetal assessments.

Common Clinical Scenarios

Complex cases involving multiple gestations and the management of potential fetal complications.

Billing Considerations

High-risk pregnancies necessitate thorough documentation of interventions and outcomes.

Coding Guidelines

Inclusion Criteria

Use O36.0112 When
  • Follow the official ICD
  • CM coding guidelines for obstetric conditions, ensuring accurate documentation of the trimester and fetal number
  • Specific criteria for maternal care related to Rh antibodies must be met, including the need for monitoring and treatment

Exclusion Criteria

Do NOT use O36.0112 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59400CPT Code

Obstetrical care including antepartum care, delivery, and postpartum care

Clinical Scenario

Used for comprehensive obstetric care in patients with Rh incompatibility.

Documentation Requirements

Complete records of all prenatal visits, including assessments and interventions.

Specialty Considerations

Obstetricians must document the specifics of care related to Rh antibody management.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the ability to track and manage complications like Rh incompatibility. This specificity aids in better patient care and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the ability to track and manage complications like Rh incompatibility. This specificity aids in better patient care and resource allocation.

Reimbursement & Billing Impact

reimbursement and compliance.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What is the significance of coding O36.0112 accurately?

Accurate coding of O36.0112 is crucial for ensuring appropriate management of Rh incompatibility, which can lead to serious fetal complications if not monitored and treated properly. It also impacts billing and reimbursement for the care provided.