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ICD-10 Guide
ICD-10 CodesO36.0912

O36.0912

Billable

Maternal care for other rhesus isoimmunization, first trimester (fetus 2)

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

Code Description

ICD-10 O36.0912 is a billable code used to indicate a diagnosis of maternal care for other rhesus isoimmunization, first trimester (fetus 2).

Key Diagnostic Point:

Maternal care for rhesus isoimmunization involves the management of a pregnant woman who has developed antibodies against Rh-positive blood cells, which can affect the fetus. In the case of O36.0912, this code specifically pertains to the first trimester of pregnancy for the second fetus in a multiple gestation. Rhesus isoimmunization can lead to serious fetal complications, including hemolytic disease of the newborn, which may manifest as fetal anemia, hydrops fetalis, or intrauterine growth restriction (IUGR). Monitoring and management strategies may include serial ultrasounds to assess fetal growth and well-being, as well as potential interventions such as intrauterine transfusions if severe anemia is detected. The first trimester is critical for establishing a care plan to mitigate risks associated with isoimmunization, ensuring both maternal and fetal health are prioritized throughout the pregnancy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Understanding of maternal-fetal blood group incompatibility
  • Knowledge of the implications of multiple gestations
  • Need for ongoing monitoring and documentation of fetal status
  • Coordination of care among multiple specialists

Audit Risk Factors

  • Inadequate documentation of maternal blood type and antibody status
  • Failure to document fetal monitoring results
  • Lack of clear care plans for managing isoimmunization
  • Improper coding of fetal complications arising from isoimmunization

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

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

Common Clinical Scenarios

Management of a pregnant woman with a history of Rh sensitization, monitoring for fetal anemia, and planning for delivery.

Billing Considerations

Accurate coding requires understanding the implications of isoimmunization on both the mother and the fetus, including potential complications.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including maternal history, ultrasound findings, and treatment plans.

Common Clinical Scenarios

Assessment of fetal well-being in cases of suspected anemia or growth restriction due to isoimmunization.

Billing Considerations

High-risk pregnancies necessitate thorough documentation of all interventions and outcomes to ensure proper coding and billing.

Coding Guidelines

Inclusion Criteria

Use O36.0912 When
  • According to the official ICD
  • 10 coding guidelines, O36
  • 0912 should be used when documenting maternal care for rhesus isoimmunization specifically in the first trimester for the second fetus
  • Coders must ensure that the diagnosis is supported by appropriate clinical documentation and that all relevant details are captured

Exclusion Criteria

Do NOT use O36.0912 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76817CPT Code

Ultrasound, fetal, transabdominal, second trimester

Clinical Scenario

Used to monitor fetal growth and well-being in cases of suspected anemia due to isoimmunization.

Documentation Requirements

Documentation must include indications for the ultrasound and findings related to fetal growth.

Specialty Considerations

Obstetricians should ensure that the ultrasound findings are clearly linked to the diagnosis of isoimmunization.

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, including those related to rhesus isoimmunization. This specificity aids in better tracking of maternal and fetal outcomes and enhances the ability to provide targeted care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including those related to rhesus isoimmunization. This specificity aids in better tracking of maternal and fetal outcomes and enhances the ability to provide targeted care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including those related to rhesus isoimmunization. This specificity aids in better tracking of maternal and fetal outcomes and enhances the ability to provide targeted care.

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 O36.0912 accurately?

Accurate coding of O36.0912 is crucial for ensuring appropriate management of maternal and fetal health in cases of rhesus isoimmunization. It allows for proper tracking of complications and ensures that the necessary interventions are documented and reimbursed.