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v1.0.0
ICD-10 Guide
ICD-10 CodesO36.0194

O36.0194

Billable

Maternal care for anti-D [Rh] antibodies, unspecified trimester (fetus 4)

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

Code Description

ICD-10 O36.0194 is a billable code used to indicate a diagnosis of maternal care for anti-d [rh] antibodies, unspecified trimester (fetus 4).

Key Diagnostic Point:

Maternal care for anti-D [Rh] antibodies is critical in managing pregnancies where the mother has developed antibodies against Rh-positive blood. This condition can lead to hemolytic disease of the fetus and newborn (HDFN), which can cause severe fetal complications such as anemia, jaundice, and even fetal distress. The management of this condition requires careful monitoring of the fetus's growth and well-being throughout the pregnancy. In cases where the fetus is affected, healthcare providers may need to perform additional interventions, including intrauterine transfusions or early delivery, depending on the severity of the fetal condition. The unspecified trimester designation indicates that the care may be relevant at any point during the pregnancy, necessitating ongoing assessment and management strategies tailored to the specific needs of the mother and fetus.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fetal response to maternal antibodies
  • Need for frequent monitoring and potential interventions
  • Documentation of maternal and fetal health status
  • Coordination of care among multiple specialties

Audit Risk Factors

  • Inadequate documentation of maternal antibody status
  • Failure to document fetal monitoring results
  • Lack of clear treatment plans for affected fetuses
  • Misclassification of trimester or fetal number

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of maternal antibody testing, fetal monitoring, and any interventions performed.

Common Clinical Scenarios

Management of pregnancies complicated by Rh sensitization, including monitoring for fetal anemia and planning for delivery.

Billing Considerations

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

Maternal-Fetal Medicine

Documentation Requirements

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

Common Clinical Scenarios

Complex cases involving multiple pregnancies or severe fetal anemia requiring specialized interventions.

Billing Considerations

High-risk pregnancies necessitate thorough documentation and coordination with other specialists.

Coding Guidelines

Inclusion Criteria

Use O36.0194 When
  • Follow official ICD
  • 10 guidelines for obstetric coding, ensuring accurate documentation of maternal and fetal conditions, and adherence to trimester specifications

Exclusion Criteria

Do NOT use O36.0194 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 complicated by Rh sensitization.

Documentation Requirements

Detailed ultrasound reports documenting fetal size and any signs of distress.

Specialty Considerations

Obstetricians should ensure that ultrasound findings are clearly linked to maternal conditions.

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 complex cases like those involving anti-D antibodies.

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 complex cases like those involving anti-D antibodies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the ability to track and manage complex cases like those involving anti-D antibodies.

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. Proper monitoring and management are essential to ensure the health of both mother and baby.