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v1.0.0
ICD-10 Guide
ICD-10 CodesZ36.86

Z36.86

Encounter for antenatal screening for cervical length

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

Code Description

ICD-10 Z36.86 is a billable code used to indicate a diagnosis of encounter for antenatal screening for cervical length.

Key Diagnostic Point:

Z36.86 is used to document encounters specifically for antenatal screening of cervical length, which is a critical preventive measure in obstetric care. This screening is essential for identifying women at risk for preterm labor, allowing for timely interventions that can improve maternal and fetal outcomes. Factors influencing health status include socioeconomic status, access to healthcare services, and education level, which can affect a woman's likelihood of receiving appropriate prenatal care. Preventive care through cervical length screening can help mitigate risks associated with cervical insufficiency and preterm birth, emphasizing the importance of regular prenatal visits. Social determinants such as housing stability, transportation access, and community resources play a significant role in a woman's ability to attend these screenings, highlighting the need for healthcare providers to consider these factors in their care plans.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for accurate documentation of the screening purpose and findings.
  • Variability in clinical guidelines regarding cervical length screening.
  • Potential overlap with other Z codes related to prenatal care.
  • Importance of capturing social determinants affecting access to care.

Audit Risk Factors

  • Inadequate documentation of the reason for the screening.
  • Failure to link the Z code with relevant clinical findings.
  • Misuse of the code in non-pregnant patients.
  • Inconsistent application of screening guidelines.

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation must include the reason for the cervical length screening, results of the screening, and any follow-up plans.

Common Clinical Scenarios

Routine prenatal visits where cervical length is assessed, high-risk pregnancies requiring closer monitoring.

Billing Considerations

Consideration of social determinants such as transportation issues that may affect a patient's ability to attend screenings.

Public Health

Documentation Requirements

Documentation should include population-level data on screening rates and outcomes, as well as any interventions implemented.

Common Clinical Scenarios

Community health initiatives aimed at increasing awareness and access to cervical length screening.

Billing Considerations

Focus on tracking health disparities and ensuring equitable access to screening services.

Coding Guidelines

Inclusion Criteria

Use Z36.86 When
  • Z codes are used to capture encounters for preventive care and screenings
  • When coding Z36
  • 86, it should be sequenced appropriately based on the primary diagnosis
  • Payer requirements may vary, so it is essential to verify coverage for cervical length screening under preventive services

Exclusion Criteria

Do NOT use Z36.86 When
No specific exclusions found.

Related CPT Codes

76817CPT Code

Ultrasound, transvaginal, pelvic

Clinical Scenario

Used during the encounter for cervical length screening.

Documentation Requirements

Documentation of the ultrasound findings and the reason for the procedure.

Specialty Considerations

Primary care providers should ensure that the procedure is linked to the Z code for accurate billing.

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 measures like cervical length screening. This specificity aids in better tracking of maternal health outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding, particularly for preventive measures like cervical length screening. This specificity aids in better tracking of maternal health outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding, particularly for preventive measures like cervical length screening. This specificity aids in better tracking of maternal health outcomes and resource allocation.

Resources

Clinical References

  • •
    ACOG Guidelines on Cervical Length Screening

Coding & Billing References

  • •
    ACOG Guidelines on Cervical Length Screening

Frequently Asked Questions

What is the importance of cervical length screening during pregnancy?

Cervical length screening is crucial for identifying women at risk for preterm birth, allowing for timely interventions that can improve outcomes for both mother and baby. It is part of comprehensive prenatal care that considers both medical and social factors affecting health.