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ICD-10 Guide
ICD-10 CodesO34.521

O34.521

Billable

Maternal care for prolapse of gravid uterus, first trimester

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

Code Description

ICD-10 O34.521 is a billable code used to indicate a diagnosis of maternal care for prolapse of gravid uterus, first trimester.

Key Diagnostic Point:

Maternal care for prolapse of the gravid uterus during the first trimester refers to the management and monitoring of a pregnant woman experiencing uterine prolapse. This condition occurs when the uterus descends into the vaginal canal due to weakened pelvic support structures, which can be exacerbated by factors such as previous cesarean deliveries or uterine scarring. In the first trimester, the focus is on assessing the severity of the prolapse, providing appropriate counseling, and determining the best management strategies to ensure maternal and fetal well-being. Care may involve pelvic floor exercises, lifestyle modifications, and in some cases, the use of a pessary. Close monitoring is essential to prevent complications such as urinary incontinence or obstructed labor as the pregnancy progresses. The healthcare provider must document the patient's obstetric history, including any previous surgeries, to tailor the care plan effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for detailed patient history including previous cesarean sections and uterine scarring.
  • Variability in clinical presentation and severity of prolapse.
  • Potential for associated complications requiring multidisciplinary management.
  • Documentation of maternal and fetal monitoring throughout the pregnancy.

Audit Risk Factors

  • Inadequate documentation of the severity of prolapse.
  • Failure to document previous obstetric history accurately.
  • Lack of clear treatment plans or follow-up notes.
  • Misclassification of the trimester of pregnancy.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed obstetric history, including previous surgeries and current symptoms.

Common Clinical Scenarios

Management of uterine prolapse in early pregnancy, counseling on pelvic floor exercises.

Billing Considerations

Consideration of the impact of previous cesarean sections on pelvic support.

Maternal-Fetal Medicine

Documentation Requirements

Thorough documentation of maternal-fetal assessments and any high-risk factors.

Common Clinical Scenarios

Monitoring of high-risk pregnancies with uterine prolapse.

Billing Considerations

Focus on fetal well-being and potential interventions.

Coding Guidelines

Inclusion Criteria

Use O34.521 When
  • According to official coding guidelines, O34
  • 521 should be used when there is a documented diagnosis of uterine prolapse during the first trimester
  • Coders must ensure that the diagnosis is supported by clinical documentation and that the appropriate trimester is indicated

Exclusion Criteria

Do NOT use O34.521 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 obstetric care in patients with uterine prolapse.

Documentation Requirements

Complete documentation of all prenatal visits and any complications.

Specialty Considerations

Obstetricians should note the implications of uterine prolapse on delivery method.

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 uterine prolapse during pregnancy. 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 obstetric conditions, including uterine prolapse during pregnancy. 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 obstetric conditions, including uterine prolapse during pregnancy. This specificity aids in better tracking of maternal health outcomes and resource allocation.

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 O34.521 accurately?

Accurate coding of O34.521 is crucial for ensuring appropriate care management for pregnant women with uterine prolapse. It helps in tracking maternal health outcomes and ensuring that patients receive the necessary interventions to prevent complications.