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v1.0.0
ICD-10 Guide
ICD-10 CodesO36.0919

O36.0919

Billable

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

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

Code Description

ICD-10 O36.0919 is a billable code used to indicate a diagnosis of maternal care for other rhesus isoimmunization, first trimester (other fetus).

Key Diagnostic Point:

Maternal care for rhesus isoimmunization refers to the management of a condition where the mother's immune system produces antibodies against the Rh factor present in the fetus's blood. This condition can lead to hemolytic disease of the newborn, which may result in fetal anemia, jaundice, and other complications. In the first trimester, the focus is on monitoring the fetus for signs of distress, growth restriction, and potential complications arising from the isoimmunization. Care may involve regular ultrasounds to assess fetal growth and well-being, as well as maternal blood tests to monitor antibody levels. If fetal distress or growth restriction is detected, further interventions may be necessary, including possible intrauterine transfusions or early delivery, depending on the severity of the condition. The management of this condition requires a multidisciplinary approach, often involving obstetricians and maternal-fetal medicine specialists to ensure optimal outcomes for both mother and fetus.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of isoimmunization and their implications.
  • Understanding the timing of interventions based on trimester.
  • Monitoring and interpreting fetal growth patterns and distress indicators.
  • Coordinating care among multiple specialties (e.g., obstetrics, maternal-fetal medicine).

Audit Risk Factors

  • Inadequate documentation of maternal antibody levels and fetal assessments.
  • Failure to document the rationale for interventions taken.
  • Misclassification of the type of isoimmunization.
  • Inconsistent coding of fetal growth restriction or distress.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

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

Common Clinical Scenarios

Routine monitoring of a pregnant patient with a history of Rh isoimmunization.

Billing Considerations

Ensure accurate coding based on trimester and specific fetal conditions.

Maternal-Fetal Medicine

Documentation Requirements

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

Common Clinical Scenarios

Management of a patient with severe Rh isoimmunization requiring close monitoring.

Billing Considerations

Focus on the implications of isoimmunization on fetal health and potential interventions.

Coding Guidelines

Inclusion Criteria

Use O36.0919 When
  • Follow the official ICD
  • CM guidelines for obstetric coding, ensuring that the code reflects the specific trimester and any complications present
  • Document all relevant clinical findings and interventions

Exclusion Criteria

Do NOT use O36.0919 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76801CPT Code

Ultrasound, pregnant uterus, transabdominal, real-time with image documentation, fetal biometry

Clinical Scenario

Used to monitor fetal growth and well-being in cases of Rh isoimmunization.

Documentation Requirements

Document indications for ultrasound and findings related to fetal growth.

Specialty Considerations

Ensure that the ultrasound report includes details relevant to 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, improving the ability to track and manage cases of rhesus isoimmunization effectively.

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 cases of rhesus isoimmunization effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the ability to track and manage cases of rhesus isoimmunization effectively.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of coding O36.0919 accurately?

Accurate coding of O36.0919 is crucial for ensuring appropriate management of maternal and fetal health, facilitating proper reimbursement, and enabling effective tracking of outcomes related to rhesus isoimmunization.