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v1.0.0
ICD-10 Guide
ICD-10 CodesO36.0924

O36.0924

Billable

Maternal care for other rhesus isoimmunization, second trimester (fetus 4)

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

Code Description

ICD-10 O36.0924 is a billable code used to indicate a diagnosis of maternal care for other rhesus isoimmunization, second trimester (fetus 4).

Key Diagnostic Point:

Maternal care for rhesus isoimmunization involves monitoring and managing the health of the mother and fetus when the mother has developed antibodies against the Rh factor, which can lead to hemolytic disease in the fetus. In the second trimester, particularly for the fourth fetus, careful assessment is crucial as the risk of complications such as fetal growth restriction and fetal distress increases. The condition requires close surveillance through ultrasound examinations to monitor fetal growth and well-being, as well as potential interventions such as intrauterine transfusions if severe anemia is detected. Maternal care may also include Rh immunoglobulin administration to prevent further sensitization and complications in future pregnancies. The management plan should be tailored to the individual needs of the mother and fetus, considering the unique challenges posed by multiple pregnancies and the potential for increased morbidity.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Multiple gestation considerations
  • Variability in fetal response to isoimmunization
  • Need for specialized monitoring techniques
  • Potential for severe complications requiring intervention

Audit Risk Factors

  • Inadequate documentation of maternal and fetal assessments
  • Failure to document interventions taken
  • Misclassification of fetal status or growth restriction
  • Lack of follow-up notes on maternal care

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of maternal health, fetal monitoring results, and interventions performed are essential.

Common Clinical Scenarios

Management of isoimmunization in pregnant women with a history of Rh incompatibility, monitoring for fetal distress.

Billing Considerations

Consideration of maternal history and previous pregnancies is crucial for accurate coding.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, ultrasound findings, and any procedures performed.

Common Clinical Scenarios

Assessment and management of fetal anemia due to isoimmunization, planning for potential transfusions.

Billing Considerations

High-risk pregnancies require a multidisciplinary approach and thorough documentation of all care provided.

Coding Guidelines

Inclusion Criteria

Use O36.0924 When
  • Follow the official ICD
  • CM guidelines for obstetric coding, ensuring that the code reflects the specific trimester and fetal number
  • Documentation must support the diagnosis and any interventions performed

Exclusion Criteria

Do NOT use O36.0924 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 for monitoring fetal growth and well-being in cases of isoimmunization.

Documentation Requirements

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

Specialty Considerations

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

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 rhesus isoimmunization.

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 rhesus isoimmunization.

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 rhesus isoimmunization.

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 O36.0924 accurately?

Accurate coding of O36.0924 is crucial for ensuring appropriate maternal care and monitoring for complications associated with rhesus isoimmunization, which can significantly impact fetal health.