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v1.0.0
ICD-10 Guide
ICD-10 CodesO34.0

O34.0

Billable

Maternal care for congenital malformation of uterus

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

Code Description

ICD-10 O34.0 is a billable code used to indicate a diagnosis of maternal care for congenital malformation of uterus.

Key Diagnostic Point:

O34.0 refers to maternal care for congenital malformations of the uterus, which can significantly impact pregnancy outcomes. Congenital uterine anomalies may include conditions such as unicornuate uterus, didelphys uterus, bicornuate uterus, and septate uterus. These abnormalities can lead to complications such as recurrent pregnancy loss, preterm labor, and abnormal fetal positioning. Maternal care for these conditions requires careful monitoring and management throughout pregnancy. Women with a history of cesarean delivery may face additional risks, including uterine rupture or complications during labor. Uterine scarring from previous surgeries can also complicate the clinical picture, necessitating a multidisciplinary approach to care. Accurate coding of O34.0 is essential for proper management and reimbursement, as it reflects the complexity of care required for these patients.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variety of congenital malformations and their implications for pregnancy
  • Need for detailed documentation of maternal history and previous surgeries
  • Potential for multiple complications requiring coordinated care
  • Variability in clinical presentation and management strategies

Audit Risk Factors

  • Inadequate documentation of maternal history and congenital anomalies
  • Failure to capture all relevant complications associated with the anomaly
  • Misclassification of the type of uterine malformation
  • Lack of interdisciplinary notes in the medical record

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed maternal history, including previous surgeries and outcomes, and current pregnancy complications.

Common Clinical Scenarios

Management of pregnancies in women with known uterine anomalies, monitoring for complications such as preterm labor.

Billing Considerations

Ensure all relevant clinical findings and treatment plans are documented to support coding.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive risk assessment and management plans for high-risk pregnancies due to uterine anomalies.

Common Clinical Scenarios

Consultations for patients with recurrent pregnancy loss or complications related to uterine malformations.

Billing Considerations

Focus on detailed ultrasound findings and any interventions performed.

Coding Guidelines

Inclusion Criteria

Use O34.0 When
  • Follow official ICD
  • CM guidelines for coding congenital malformations, ensuring that all relevant clinical details are captured
  • Document the specific type of malformation and any associated complications to support the use of O34

Exclusion Criteria

Do NOT use O34.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59400CPT Code

Obstetrical care including antepartum care, delivery, and postpartum care

Clinical Scenario

Used for comprehensive care of a patient with a congenital uterine anomaly throughout pregnancy.

Documentation Requirements

Document all visits, assessments, and any complications related to the anomaly.

Specialty Considerations

Ensure that all specialty consultations are noted, especially if maternal-fetal medicine is involved.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital uterine anomalies, improving the ability to capture the complexity of these cases and ensuring appropriate reimbursement for the care provided.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital uterine anomalies, improving the ability to capture the complexity of these cases and ensuring appropriate reimbursement for the care provided.

Reimbursement & Billing Impact

reimbursement for the care provided.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the implications of a congenital uterine anomaly during pregnancy?

Congenital uterine anomalies can lead to various complications, including recurrent pregnancy loss, preterm labor, and abnormal fetal positioning. Careful monitoring and management are essential to optimize outcomes.