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v1.0.0
ICD-10 Guide
ICD-10 CodesO36.093

O36.093

Billable

Maternal care for other rhesus isoimmunization, third trimester

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

Code Description

ICD-10 O36.093 is a billable code used to indicate a diagnosis of maternal care for other rhesus isoimmunization, third trimester.

Key Diagnostic Point:

Maternal care for other rhesus isoimmunization in the third trimester refers to the management and monitoring of pregnant women who have developed isoimmunization due to Rh incompatibility. This condition arises when an Rh-negative mother carries an Rh-positive fetus, leading to the mother's immune system producing antibodies against the fetal red blood cells. In the third trimester, careful monitoring is crucial as the risk of fetal complications increases, including hemolytic disease of the newborn, fetal growth restriction, and fetal distress. Management may involve serial ultrasounds to assess fetal growth, non-stress tests to monitor fetal heart rate patterns, and potential interventions such as intrauterine transfusions if severe anemia is detected. The goal is to ensure the health and safety of both the mother and the fetus, addressing any complications that may arise due to the isoimmunization.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of isoimmunization and their implications.
  • Understanding the timing and frequency of monitoring required in the third trimester.
  • Recognizing associated fetal complications such as growth restriction and distress.
  • Navigating the documentation requirements for high-risk pregnancies.

Audit Risk Factors

  • Inadequate documentation of maternal and fetal monitoring.
  • Failure to document the rationale for interventions.
  • Misclassification of the severity of isoimmunization.
  • Lack of clear linkage between diagnosis and treatment provided.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

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

Common Clinical Scenarios

Management of a pregnant woman with a history of Rh isoimmunization presenting for routine care in the third trimester.

Billing Considerations

Ensure accurate coding of any interventions performed, such as Rh immunoglobulin administration.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk assessments, including ultrasound findings and fetal heart rate monitoring.

Common Clinical Scenarios

A patient with Rh isoimmunization requiring close monitoring for fetal anemia and growth restriction.

Billing Considerations

Consideration of potential intrauterine transfusions and their documentation.

Coding Guidelines

Inclusion Criteria

Use O36.093 When
  • Follow official ICD
  • CM guidelines for obstetric coding, ensuring accurate documentation of maternal and fetal conditions, and adherence to pregnancy
  • specific criteria for coding complications

Exclusion Criteria

Do NOT use O36.093 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76815CPT 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 indications for ultrasound and findings.

Specialty Considerations

Obstetricians should 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, including isoimmunization, which enhances the ability to track and manage these cases effectively.

ICD-9 vs ICD-10

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

Reimbursement & Billing Impact

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

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 O36.093 accurately?

Accurate coding of O36.093 is crucial for ensuring appropriate management of Rh isoimmunization, which can have serious implications for fetal health. It also supports proper reimbursement and reflects the complexity of care provided.