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ICD-10 Guide
ICD-10 CodesO34.00

O34.00

Billable

Maternal care for unspecified congenital malformation of uterus, unspecified trimester

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

Code Description

ICD-10 O34.00 is a billable code used to indicate a diagnosis of maternal care for unspecified congenital malformation of uterus, unspecified trimester.

Key Diagnostic Point:

O34.00 refers to maternal care for women diagnosed with congenital malformations of the uterus that are unspecified. These malformations can include conditions such as uterine didelphys, unicornuate uterus, or septate uterus, which may not be explicitly documented. The presence of these abnormalities can significantly impact pregnancy outcomes, necessitating careful monitoring and management throughout the pregnancy. Women with congenital uterine anomalies may experience complications such as recurrent pregnancy loss, preterm labor, or abnormal fetal positioning. The management of these patients often requires a multidisciplinary approach, including obstetricians, maternal-fetal medicine specialists, and possibly reproductive endocrinologists. It is crucial for healthcare providers to document any known history of uterine abnormalities, previous cesarean deliveries, or uterine scarring, as these factors can influence the course of care and delivery planning. Accurate coding is essential for ensuring appropriate care and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of congenital malformations
  • Need for detailed patient history regarding previous surgeries
  • Potential for multiple congenital anomalies complicating coding
  • Differentiation between congenital and acquired uterine conditions

Audit Risk Factors

  • Inadequate documentation of congenital malformations
  • Failure to note previous cesarean sections or uterine surgeries
  • Misclassification of congenital versus acquired conditions
  • Lack of detailed clinical notes regarding maternal care

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Complete obstetric history, including any congenital anomalies, previous surgeries, and current pregnancy complications.

Common Clinical Scenarios

Management of a patient with a known congenital uterine anomaly presenting for prenatal care.

Billing Considerations

Ensure thorough documentation of any complications arising from the congenital malformation.

Maternal-Fetal Medicine

Documentation Requirements

Detailed records of high-risk factors, including congenital malformations and their potential impact on pregnancy.

Common Clinical Scenarios

Monitoring a high-risk pregnancy with a history of uterine anomalies and previous cesarean deliveries.

Billing Considerations

Focus on the implications of uterine anomalies on fetal development and delivery planning.

Coding Guidelines

Inclusion Criteria

Use O34.00 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when there is clear documentation of a congenital malformation of the uterus
  • The trimester of care should be specified when possible, although this code is for unspecified trimester

Exclusion Criteria

Do NOT use O34.00 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59400CPT Code

Obstetric care including antepartum care, delivery, and postpartum care

Clinical Scenario

Used for comprehensive obstetric care for patients with congenital uterine anomalies.

Documentation Requirements

Complete records of all prenatal visits, delivery details, and postpartum follow-up.

Specialty Considerations

Obstetricians should ensure that all aspects of care are documented to support the coding.

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 accuracy of data collection and reimbursement processes. It has also highlighted the need for thorough documentation in obstetric care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital uterine anomalies, improving the accuracy of data collection and reimbursement processes. It has also highlighted the need for thorough documentation in obstetric care.

Reimbursement & Billing Impact

reimbursement processes. It has also highlighted the need for thorough documentation in obstetric care.

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 should I document to support the use of O34.00?

To support the use of O34.00, document any known congenital uterine anomalies, previous surgeries, and any complications during the pregnancy. Ensure that the patient's obstetric history is complete and detailed.