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v1.0.0
ICD-10 Guide
ICD-10 CodesO34.13

O34.13

Billable

Maternal care for benign tumor of corpus uteri, third trimester

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

Code Description

ICD-10 O34.13 is a billable code used to indicate a diagnosis of maternal care for benign tumor of corpus uteri, third trimester.

Key Diagnostic Point:

O34.13 refers to maternal care for a benign tumor located in the corpus uteri during the third trimester of pregnancy. This condition may involve careful monitoring and management due to the potential impact on the pregnancy and delivery. Benign tumors, such as fibroids, can affect the uterine environment, potentially leading to complications such as abnormal fetal positioning, increased risk of cesarean delivery, or uterine scarring. In the third trimester, the size and location of the tumor may necessitate additional imaging or interventions to ensure maternal and fetal safety. The presence of a benign tumor may also complicate the management of previous cesarean deliveries, as uterine scarring can influence surgical decisions during labor and delivery. Proper documentation of the tumor's characteristics, maternal symptoms, and any interventions is crucial for accurate coding and optimal patient care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between benign and malignant tumors
  • Impact of previous cesarean deliveries on current pregnancy management
  • Potential complications arising from the tumor's size and location
  • Need for multidisciplinary care involving obstetricians and maternal-fetal medicine specialists

Audit Risk Factors

  • Inadequate documentation of tumor characteristics
  • Failure to note previous cesarean history
  • Lack of clear treatment plans or follow-up care
  • Misclassification of tumor type (benign vs. malignant)

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include details about the tumor's size, location, and any symptoms experienced by the patient. Additionally, previous obstetric history, including cesarean deliveries, should be clearly documented.

Common Clinical Scenarios

Common scenarios include monitoring a pregnant patient with a known fibroid, managing labor in a patient with a history of cesarean delivery and a benign tumor, and planning for delivery in cases where the tumor may affect fetal positioning.

Billing Considerations

Coders should be aware of the implications of uterine scarring from previous surgeries and how this may affect the current pregnancy and delivery plan.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancy documentation should include detailed assessments of the tumor's impact on maternal and fetal health, as well as any interventions planned or performed.

Common Clinical Scenarios

Complex scenarios may involve managing a patient with multiple risk factors, including a benign tumor, previous cesarean deliveries, and other comorbidities.

Billing Considerations

High-risk coding requires careful attention to detail and comprehensive documentation to ensure all aspects of care are captured.

Coding Guidelines

Inclusion Criteria

Use O34.13 When
  • Official coding guidelines for obstetrics emphasize the importance of documenting the specific nature of the tumor, its impact on the pregnancy, and any relevant obstetric history
  • Coders should ensure that all relevant details are captured to support the use of O34

Exclusion Criteria

Do NOT use O34.13 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59510CPT Code

Cesarean delivery

Clinical Scenario

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

Documentation Requirements

Documentation must include the indication for cesarean delivery and any complications related to the tumor.

Specialty Considerations

Obstetricians should document the surgical approach and any findings related to the tumor during the procedure.

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 benign tumors. This specificity improves the accuracy of data collection and enhances the ability to track outcomes related to maternal and fetal health.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including benign tumors. This specificity improves the accuracy of data collection and enhances the ability to track outcomes related to maternal and fetal health.

Reimbursement & Billing Impact

reimbursement and to reflect the complexity of 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 benign tumor during pregnancy?

Benign tumors can affect pregnancy management, including the risk of cesarean delivery and the need for monitoring. It is essential to document the tumor's characteristics and any symptoms to ensure appropriate care.