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v1.0.0
ICD-10 Guide
ICD-10 CodesO31.33

O31.33

Billable

Continuing pregnancy after elective fetal reduction of one fetus or more, third trimester

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

Code Description

ICD-10 O31.33 is a billable code used to indicate a diagnosis of continuing pregnancy after elective fetal reduction of one fetus or more, third trimester.

Key Diagnostic Point:

O31.33 refers to the clinical scenario where a pregnancy continues after an elective fetal reduction procedure has been performed on one or more fetuses during the third trimester. This situation often arises in cases of multiple gestations, where the risk of complications increases with the number of fetuses. Elective fetal reduction is typically performed to improve outcomes for the remaining fetuses, particularly in cases of twin-to-twin transfusion syndrome (TTTS), where one twin receives more blood flow than the other, leading to significant health risks for both. The decision to continue the pregnancy after such a procedure involves careful monitoring and management of potential complications, including preterm labor, intrauterine growth restriction, and the psychological impact on the mother. The ongoing care during this period requires a multidisciplinary approach, often involving obstetricians, maternal-fetal medicine specialists, and neonatologists to ensure the best possible outcomes for both the mother and the surviving fetus or fetuses.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Need for detailed documentation of the fetal reduction procedure and its indications.
  • Management of potential complications specific to multiple gestations.
  • Coordination of care among multiple specialties.
  • Monitoring for psychological impacts on the mother post-procedure.

Audit Risk Factors

  • Inadequate documentation of the fetal reduction procedure.
  • Failure to document ongoing monitoring and management of complications.
  • Misclassification of the gestational age at the time of coding.
  • Lack of clarity in the medical necessity for the fetal reduction.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of the fetal reduction procedure, ongoing assessments of the remaining fetus or fetuses, and any complications arising during the third trimester.

Common Clinical Scenarios

Management of pregnancies with multiple gestations, monitoring for complications such as preterm labor or growth restrictions.

Billing Considerations

Consideration of the psychological impact on the mother and the need for supportive care.

Maternal-Fetal Medicine

Documentation Requirements

Thorough documentation of high-risk factors, including the rationale for fetal reduction and ongoing assessments of fetal well-being.

Common Clinical Scenarios

Management of twin-to-twin transfusion syndrome and other complications associated with multiple gestations.

Billing Considerations

Focus on the high-risk nature of the pregnancy and the need for specialized monitoring and interventions.

Coding Guidelines

Inclusion Criteria

Use O31.33 When
  • According to official obstetric coding guidelines, O31
  • 33 should be used when documenting a continuing pregnancy after elective fetal reduction in the third trimester
  • Coders must ensure that all relevant clinical details are captured, including the number of fetuses reduced and the gestational age at the time of the procedure

Exclusion Criteria

Do NOT use O31.33 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59840CPT Code

Fetal reduction procedure

Clinical Scenario

Used when a patient undergoes a fetal reduction procedure during a multiple gestation.

Documentation Requirements

Documentation must include the indication for the procedure and details of the reduction.

Specialty Considerations

Obstetricians must ensure that all risks and benefits are discussed with the patient.

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 O31.33, which provides better granularity in capturing the complexities of multiple gestations and fetal reduction procedures.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including O31.33, which provides better granularity in capturing the complexities of multiple gestations and fetal reduction procedures.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including O31.33, which provides better granularity in capturing the complexities of multiple gestations and fetal reduction procedures.

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 O31.33?

Coding O31.33 is significant as it reflects the complexities involved in managing pregnancies after elective fetal reduction, particularly in high-risk scenarios such as multiple gestations. Accurate coding ensures appropriate reimbursement and highlights the need for specialized care.