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ICD-10 Guide
ICD-10 CodesO36.0121

O36.0121

Billable

Maternal care for anti-D [Rh] antibodies, second trimester (fetus 1)

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

Code Description

ICD-10 O36.0121 is a billable code used to indicate a diagnosis of maternal care for anti-d [rh] antibodies, second trimester (fetus 1).

Key Diagnostic Point:

O36.0121 refers to maternal care for a pregnancy complicated by the presence of anti-D (Rh) antibodies during the second trimester for the first fetus. This condition arises when an Rh-negative mother carries an Rh-positive fetus, leading to the potential for hemolytic disease of the newborn (HDN). The presence of these antibodies can cause fetal complications such as anemia, jaundice, and in severe cases, fetal distress or intrauterine growth restriction (IUGR). Monitoring and management strategies may include regular ultrasound assessments to evaluate fetal growth and well-being, as well as potential interventions like intrauterine transfusions if significant anemia is detected. The management of anti-D antibodies is crucial to prevent adverse outcomes and ensure the health of both mother and fetus throughout the pregnancy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Understanding the implications of Rh incompatibility on fetal health.
  • Differentiating between mild and severe cases of antibody presence.
  • Knowledge of monitoring protocols and interventions for affected pregnancies.
  • Navigating documentation requirements for high-risk pregnancies.

Audit Risk Factors

  • Inadequate documentation of maternal antibody testing results.
  • Failure to document fetal monitoring and assessment findings.
  • Misclassification of the severity of the condition.
  • Omission of co-existing conditions that may affect coding.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of maternal blood tests, ultrasound findings, and any interventions performed.

Common Clinical Scenarios

Routine monitoring of fetal growth in pregnancies complicated by anti-D antibodies.

Billing Considerations

Accurate coding requires understanding of the timing of antibody testing and its implications for fetal health.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk assessments, including detailed ultrasound reports and management plans.

Common Clinical Scenarios

Management of severe fetal anemia due to Rh incompatibility requiring intrauterine transfusion.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use O36.0121 When
  • According to ICD
  • 10 coding guidelines, O36
  • 0121 should be used when there is documented evidence of anti
  • D antibodies in the mother during the second trimester
  • Coders must ensure that the documentation supports the diagnosis and reflects the ongoing maternal care provided

Exclusion Criteria

Do NOT use O36.0121 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 to monitor fetal growth and well-being in pregnancies with anti-D antibodies.

Documentation Requirements

Ultrasound reports must detail findings related to fetal growth and any signs of distress.

Specialty Considerations

Obstetricians must ensure that ultrasound findings are clearly linked to the diagnosis of anti-D antibodies.

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, such as anti-D antibodies, improving the accuracy of maternal-fetal care documentation and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of maternal conditions, such as anti-D antibodies, improving the accuracy of maternal-fetal care documentation and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What are the implications of anti-D antibodies on fetal health?

Anti-D antibodies can lead to hemolytic disease of the newborn, causing complications such as anemia, jaundice, and in severe cases, fetal distress or intrauterine growth restriction. Regular monitoring and appropriate interventions are crucial to manage these risks.