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v1.0.0
ICD-10 Guide
ICD-10 CodesO34.1

O34.1

Billable

Maternal care for benign tumor of corpus uteri

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

Code Description

ICD-10 O34.1 is a billable code used to indicate a diagnosis of maternal care for benign tumor of corpus uteri.

Key Diagnostic Point:

O34.1 refers to maternal care for benign tumors located in the corpus uteri, which can include conditions such as fibroids or adenomyosis. These tumors may not pose immediate risks to the pregnancy but can complicate maternal care and delivery. The presence of a benign tumor can lead to increased monitoring during pregnancy, particularly if the tumor is large or symptomatic. It may also influence the mode of delivery, especially in cases where the tumor obstructs the birth canal or is associated with previous cesarean deliveries. Careful assessment of the tumor's size, location, and symptoms is essential for managing the pregnancy effectively. Additionally, the presence of uterine scarring from previous cesarean sections may complicate the management of benign tumors, necessitating a multidisciplinary approach to ensure both maternal and fetal safety throughout the pregnancy and delivery process.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in tumor size and location affecting delivery options
  • Potential for increased monitoring and interventions
  • Need for coordination with surgical teams if intervention is required
  • Impact of previous cesarean sections on delivery planning

Audit Risk Factors

  • Inadequate documentation of tumor characteristics
  • Failure to note previous cesarean history
  • Lack of clear treatment plans or monitoring protocols
  • Misclassification of tumor type or impact on pregnancy

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of the tumor's size, location, and symptoms, as well as any interventions planned or performed.

Common Clinical Scenarios

Management of a pregnant patient with a known fibroid, monitoring for complications, and planning for delivery.

Billing Considerations

Consideration of the impact of the tumor on labor and delivery, including potential need for cesarean delivery.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of maternal and fetal assessments, including imaging studies and consultations.

Common Clinical Scenarios

High-risk pregnancies involving large fibroids or significant uterine scarring requiring specialized management.

Billing Considerations

Close monitoring of fetal growth and maternal health, with potential for surgical intervention if complications arise.

Coding Guidelines

Inclusion Criteria

Use O34.1 When
  • According to official coding guidelines, O34
  • 1 should be used when a benign tumor of the corpus uteri is documented during pregnancy
  • Coders must ensure that the diagnosis is clearly stated in the medical record and that any associated conditions, such as previous cesarean deliveries, are also documented

Exclusion Criteria

Do NOT use O34.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59510CPT Code

Cesarean delivery, including postpartum care

Clinical Scenario

Used when a cesarean delivery is performed due to complications from a benign tumor.

Documentation Requirements

Documentation must include indication for cesarean related to the tumor.

Specialty Considerations

Obstetricians must document the rationale for surgical intervention.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of maternal conditions, including benign tumors of the corpus uteri. 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 more specific coding of maternal conditions, including benign tumors of the corpus uteri. This specificity aids in better tracking of maternal health outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of maternal conditions, including benign tumors of the corpus uteri. This specificity aids in better tracking of maternal health outcomes and resource allocation.

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 be documented for O34.1 coding?

Documentation should include the size and location of the benign tumor, any symptoms experienced by the patient, previous obstetric history, and the management plan during pregnancy.