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ICD-10 Guide
ICD-10 CodesO36.0133

O36.0133

Billable

Maternal care for anti-D [Rh] antibodies, third trimester (fetus 3)

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

Code Description

ICD-10 O36.0133 is a billable code used to indicate a diagnosis of maternal care for anti-d [rh] antibodies, third trimester (fetus 3).

Key Diagnostic Point:

O36.0133 refers to maternal care for a pregnant woman who has developed anti-D (Rh) antibodies during her third trimester, specifically concerning the third fetus. This condition arises when an Rh-negative mother is exposed to Rh-positive fetal blood, leading to the production of antibodies that can cross the placenta and affect the fetus. The presence of these antibodies can lead to complications such as hemolytic disease of the newborn, fetal growth restriction, and fetal distress. Monitoring and management strategies are crucial during this period to assess fetal well-being, including ultrasound evaluations for growth and Doppler studies to assess blood flow. Maternal care may involve additional interventions such as Rh immunoglobulin administration, close surveillance of fetal heart rate patterns, and potential early delivery if fetal distress is noted. The management of anti-D antibodies is essential to prevent severe outcomes for the fetus and ensure a safe delivery.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for accurate identification of maternal and fetal blood types.
  • Monitoring for potential fetal complications such as anemia and hydrops.
  • Documentation of maternal antibody screening and follow-up care.
  • Coordination of care among obstetricians, maternal-fetal medicine specialists, and pediatricians.

Audit Risk Factors

  • Inadequate documentation of maternal antibody status.
  • Failure to document fetal monitoring results.
  • Lack of clear treatment plans for managing anti-D antibodies.
  • Inconsistent coding of fetal complications related to maternal conditions.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of maternal blood type, antibody screening results, and fetal monitoring.

Common Clinical Scenarios

Management of Rh incompatibility in pregnancies, monitoring for fetal distress, and planning for delivery.

Billing Considerations

Consideration of maternal history and previous pregnancies affected by Rh incompatibility.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, ultrasound findings, and management plans.

Common Clinical Scenarios

Assessment of fetal growth restriction and planning for potential interventions.

Billing Considerations

Close collaboration with obstetricians and pediatricians for coordinated care.

Coding Guidelines

Inclusion Criteria

Use O36.0133 When
  • According to official coding guidelines, O36
  • 0133 should be used when there is documented evidence of maternal anti
  • D antibodies during the third trimester
  • Coders must ensure that the documentation supports the diagnosis and reflects the complexity of care provided

Exclusion Criteria

Do NOT use O36.0133 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76801CPT Code

Ultrasound, obstetric, transabdominal, real-time with image documentation, fetal biometry

Clinical Scenario

Used for monitoring fetal growth in patients with anti-D antibodies.

Documentation Requirements

Document the reason for the ultrasound and findings related to fetal growth.

Specialty Considerations

Obstetricians should ensure that the ultrasound is performed in accordance with guidelines for high-risk pregnancies.

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 data collection 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 data collection 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 is the significance of anti-D antibodies during pregnancy?

Anti-D antibodies can lead to serious complications for the fetus, including hemolytic disease, which can cause anemia and other health issues. Monitoring and management are essential to ensure fetal well-being.