ICD-10 Guide

Z37.3

Twins, one liveborn and one stillborn

BILLABLE STATUSYes

IMPLEMENTATION DATEOctober 1, 2015

LAST UPDATED09/12/2025

Code Description

ICD-10 Z37.3 is a billable code used to indicate a diagnosis of twins, one liveborn and one stillborn.

Key Diagnostic Point:

Z37.3 is used to classify cases where one twin is liveborn and the other is stillborn. This situation can arise due to various factors, including maternal health conditions, genetic abnormalities, or complications during pregnancy. The health status of the mother and the surviving twin may be influenced by social determinants such as access to prenatal care, socioeconomic status, and support systems. Preventive care is crucial in managing pregnancies with multiple gestations, including regular screenings for potential complications. Aftercare for the mother may involve psychological support due to the emotional impact of losing a twin, as well as physical health monitoring. Documentation should reflect the circumstances surrounding the birth, including any complications and the care provided to both the liveborn and stillborn twin.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

Need for detailed documentation of the circumstances of the stillbirth.
Potential for emotional and psychological considerations in aftercare.
Variability in coding based on the outcome of the pregnancy.
Importance of capturing social determinants affecting maternal health.

Audit Risk Factors

Inadequate documentation of the stillborn twin's condition.
Failure to capture relevant social determinants affecting maternal health.
Incorrect sequencing of codes related to the birth outcome.
Lack of follow-up documentation for aftercare services provided.

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include prenatal care visits, screenings for complications, and aftercare plans for the mother and surviving twin.

Common Clinical Scenarios

Routine checkups during pregnancy, management of complications, and psychological support after delivery.

Billing Considerations

Consideration of social determinants such as access to healthcare, mental health support, and family dynamics.

Public Health

Documentation Requirements

Population-level data collection on twin births, stillbirth rates, and maternal health outcomes.

Common Clinical Scenarios

Epidemiological studies on the incidence of stillbirths and preventive measures in high-risk populations.

Billing Considerations

Tracking health disparities and access to care for mothers of multiples.

Coding Guidelines

Inclusion Criteria

Use Z37.3 When

Z codes are used to indicate factors influencing health status and contact with health services
3 should be sequenced appropriately, often following the primary diagnosis related to the delivery
Payer requirements may vary, so it is essential to check specific guidelines for coverage of aftercare services

Exclusion Criteria

Do NOT use Z37.3 When

No specific exclusions found.

Related CPT Codes

99406CPT Code

Smoking and tobacco use cessation counseling visit

Clinical Scenario

Used in conjunction with Z37.3 when counseling the mother on health behaviors post-delivery.

Documentation Requirements

Document the counseling session and any referrals made.

Specialty Considerations

Important for primary care providers to address lifestyle factors affecting maternal health.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding outcomes of multiple births, enhancing the ability to capture the complexities of cases like Z37.3.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding outcomes of multiple births, enhancing the ability to capture the complexities of cases like Z37.3.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding outcomes of multiple births, enhancing the ability to capture the complexities of cases like Z37.3.

Resources

Clinical References

•
CDC Guidelines on Multiple Births

Coding & Billing References

•
CDC Guidelines on Multiple Births

Frequently Asked Questions

What documentation is required for coding Z37.3?

Documentation must include details of the delivery, the condition of both twins, and any aftercare provided to the mother. It should also address any psychological support offered due to the loss.

ICD-10 Z37.3 is a billable code used to indicate a diagnosis of twins, one liveborn and one stillborn.