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v1.0.0
ICD-10 Guide
ICD-10 CodesO36.0120

O36.0120

Billable

Maternal care for anti-D [Rh] antibodies, second trimester (not applicable or unspecified)

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

Code Description

ICD-10 O36.0120 is a billable code used to indicate a diagnosis of maternal care for anti-d [rh] antibodies, second trimester (not applicable or unspecified).

Key Diagnostic Point:

Maternal care for anti-D [Rh] antibodies during the second trimester is crucial for managing potential fetal complications arising from Rh incompatibility. This condition occurs when an Rh-negative mother carries an Rh-positive fetus, leading to the mother's immune system producing antibodies against the fetal red blood cells. If untreated, this can result in hemolytic disease of the newborn (HDN), characterized by fetal anemia, jaundice, and in severe cases, fetal distress or intrauterine growth restriction (IUGR). Monitoring during this period includes regular ultrasounds to assess fetal growth and well-being, as well as blood tests to evaluate the mother's antibody levels. The management may involve administering Rh immunoglobulin (RhoGAM) to prevent antibody formation and close monitoring of fetal health to mitigate risks associated with fetal anemia and distress. Proper documentation of maternal antibody status, fetal assessments, and any interventions is essential for accurate coding and care continuity.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Understanding of Rh incompatibility and its implications for fetal health.
  • Need for regular monitoring and documentation of maternal and fetal status.
  • Variability in clinical presentation and management strategies.
  • Potential for co-existing conditions that may complicate coding.

Audit Risk Factors

  • Inadequate documentation of maternal antibody testing and results.
  • Failure to document fetal monitoring and growth assessments.
  • Misclassification of the trimester or condition severity.
  • Omission of interventions such as RhoGAM administration.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of maternal antibody status, fetal assessments, and any interventions performed.

Common Clinical Scenarios

Routine monitoring of an Rh-negative mother with an Rh-positive fetus, management of fetal distress due to anemia.

Billing Considerations

Ensure accurate coding of any additional complications or interventions related to Rh incompatibility.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk pregnancy management, including ultrasound findings and maternal-fetal assessments.

Common Clinical Scenarios

Management of severe fetal anemia or IUGR due to Rh incompatibility.

Billing Considerations

Focus on detailed fetal monitoring and interventions to prevent adverse outcomes.

Coding Guidelines

Inclusion Criteria

Use O36.0120 When
  • Follow the official ICD
  • CM guidelines for obstetric coding, ensuring accurate trimester designation and documentation of maternal and fetal conditions
  • Use additional codes as necessary to capture any complications

Exclusion Criteria

Do NOT use O36.0120 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

36415CPT Code

Blood test for antibody screening

Clinical Scenario

Used to monitor Rh-negative mothers for anti-D antibodies.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Ensure that results are communicated to the obstetric care team.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of maternal conditions, improving the ability to track and manage complications related to Rh incompatibility.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of maternal conditions, improving the ability to track and manage complications related to Rh incompatibility.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of maternal conditions, improving the ability to track and manage complications related to Rh incompatibility.

Resources

Clinical References

  • •
    ACOG Practice Bulletin on Rh Incompatibility

Coding & Billing References

  • •
    ACOG Practice Bulletin on Rh Incompatibility

Frequently Asked Questions

What is the significance of coding O36.0120?

Coding O36.0120 is essential for tracking maternal care related to Rh incompatibility, which can have serious implications for fetal health. Accurate coding ensures appropriate management and intervention strategies are documented and reimbursed.