ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesZ36.83

Z36.83

Encounter for fetal screening for congenital cardiac abnormalities

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/12/2025

Code Description

ICD-10 Z36.83 is a billable code used to indicate a diagnosis of encounter for fetal screening for congenital cardiac abnormalities.

Key Diagnostic Point:

Z36.83 is used to document encounters specifically for fetal screening aimed at identifying congenital cardiac abnormalities. This screening is crucial as congenital heart defects are among the most common birth defects, affecting approximately 1 in 100 births. The screening typically occurs during routine prenatal visits, often through ultrasound or echocardiography, and is influenced by various factors including maternal health, family history, and access to healthcare services. Social determinants of health, such as socioeconomic status, education, and access to prenatal care, significantly impact the likelihood of receiving timely screenings. Preventive care through early detection can lead to better outcomes for both the mother and the fetus, allowing for appropriate planning and management of potential complications. Documentation must reflect the reason for the screening, any relevant maternal history, and the results of the screening to ensure accurate coding and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for detailed maternal history and risk factors
  • Variability in screening protocols across providers
  • Documentation of results and follow-up plans
  • Potential for multiple encounters related to screening

Audit Risk Factors

  • Inadequate documentation of maternal risk factors
  • Failure to document the results of the screening
  • Incorrect sequencing of codes related to the encounter
  • Lack of follow-up documentation if abnormalities are found

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include maternal health history, reason for screening, and results. Any referrals or follow-up plans must also be noted.

Common Clinical Scenarios

Routine prenatal visits where fetal screening is performed, follow-up visits for abnormal findings.

Billing Considerations

Consideration of social determinants such as access to care, education level, and support systems that may affect screening uptake.

Public Health

Documentation Requirements

Documentation should include population health data, screening rates, and outcomes to track effectiveness of screening programs.

Common Clinical Scenarios

Community health initiatives aimed at increasing awareness and access to fetal screenings.

Billing Considerations

Focus on health disparities and outreach efforts to underserved populations.

Coding Guidelines

Inclusion Criteria

Use Z36.83 When
  • Z codes are used when a patient encounters health services for reasons other than a current illness or injury
  • 83 should be used when the primary purpose of the encounter is for fetal screening
  • It is important to sequence this code appropriately, especially if there are other diagnoses or complications present
  • Payer requirements may vary, so it is essential to verify coverage for preventive screenings

Exclusion Criteria

Do NOT use Z36.83 When
No specific exclusions found.

Related CPT Codes

76811CPT Code

Ultrasound, fetal echocardiography

Clinical Scenario

Used during the encounter for fetal screening for congenital cardiac abnormalities.

Documentation Requirements

Documentation must include the indication for the echocardiogram and the findings.

Specialty Considerations

Primary care providers should ensure that referrals for echocardiography are well-documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding, particularly for preventive services like fetal screenings. Z36.83 provides a clear indication of the purpose of the encounter, which aids in tracking and improving maternal and fetal health outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding, particularly for preventive services like fetal screenings. Z36.83 provides a clear indication of the purpose of the encounter, which aids in tracking and improving maternal and fetal health outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding, particularly for preventive services like fetal screenings. Z36.83 provides a clear indication of the purpose of the encounter, which aids in tracking and improving maternal and fetal health outcomes.

Resources

Clinical References

  • •
    ACOG Guidelines for Fetal Screening

Coding & Billing References

  • •
    ACOG Guidelines for Fetal Screening

Frequently Asked Questions

What are the key factors to document when using Z36.83?

Key factors include maternal health history, reason for the screening, results of the screening, and any follow-up plans. It's also important to document any social determinants that may impact the patient's access to care.