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v1.0.0
ICD-10 Guide
ICD-10 CodesO36.0925

O36.0925

Billable

Maternal care for other rhesus isoimmunization, second trimester (fetus 5)

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

Code Description

ICD-10 O36.0925 is a billable code used to indicate a diagnosis of maternal care for other rhesus isoimmunization, second trimester (fetus 5).

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, the focus is on assessing fetal well-being, as the risk of complications such as fetal growth restriction and fetal distress increases. Rhesus isoimmunization can lead to anemia in the fetus, necessitating careful ultrasound evaluations and possibly intrauterine transfusions. Maternal care includes regular blood tests to monitor antibody levels, ultrasound assessments to evaluate fetal growth and amniotic fluid levels, and planning for delivery to mitigate risks associated with the condition. The management plan may involve a multidisciplinary approach, including 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

  • Requires understanding of immunology related to Rh factor
  • Involves monitoring multiple fetal parameters
  • Potential for high-risk interventions
  • Need for interdisciplinary communication

Audit Risk Factors

  • Inadequate documentation of maternal antibody testing
  • Failure to document fetal monitoring results
  • Lack of clear care plans for high-risk pregnancies
  • Misclassification of fetal conditions

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

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

Common Clinical Scenarios

Management of Rh isoimmunization during routine prenatal visits, monitoring for fetal growth restriction.

Billing Considerations

Ensure accurate coding of maternal and fetal conditions, and document all assessments and interventions thoroughly.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk assessments, including ultrasound findings and laboratory results.

Common Clinical Scenarios

Complex cases involving intrauterine transfusions or advanced monitoring techniques.

Billing Considerations

Focus on the multidisciplinary approach and the need for detailed documentation of all care provided.

Coding Guidelines

Inclusion Criteria

Use O36.0925 When
  • Follow the official ICD
  • CM guidelines for obstetric coding, ensuring that the trimester and specific fetal conditions are accurately documented
  • Use additional codes as necessary to capture any complications or interventions

Exclusion Criteria

Do NOT use O36.0925 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76801CPT Code

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

Clinical Scenario

Used for routine monitoring of fetal growth and well-being in cases of Rh isoimmunization.

Documentation Requirements

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

Specialty Considerations

Ensure that the ultrasound is performed by qualified personnel and that results are communicated effectively.

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 O36.0925 accurately?

Accurate coding of O36.0925 is crucial for ensuring appropriate management of high-risk pregnancies, facilitating proper reimbursement, and supporting quality care initiatives.