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v1.0.0
ICD-10 Guide
ICD-10 CodesO34.90

O34.90

Billable

Maternal care for abnormality of pelvic organ, unspecified, unspecified trimester

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

Code Description

ICD-10 O34.90 is a billable code used to indicate a diagnosis of maternal care for abnormality of pelvic organ, unspecified, unspecified trimester.

Key Diagnostic Point:

O34.90 refers to maternal care for abnormalities of pelvic organs that are unspecified and can occur during any trimester of pregnancy. This code is utilized when there is a documented abnormality in the pelvic organs, such as the uterus, ovaries, or vagina, but the specific nature of the abnormality is not detailed. Common conditions that may fall under this code include uterine fibroids, pelvic organ prolapse, or congenital anomalies. These abnormalities can impact pregnancy management, necessitating careful monitoring and potential intervention. In cases of previous cesarean deliveries, the presence of uterine scarring may complicate the pregnancy, requiring additional surveillance for risks such as uterine rupture or abnormal placentation. Proper documentation is crucial to ensure appropriate coding and to reflect the complexity of care provided to the patient.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Lack of specificity in the diagnosis
  • Variability in pelvic organ abnormalities
  • Potential for multiple concurrent conditions
  • Need for detailed documentation to support coding

Audit Risk Factors

  • Insufficient documentation of the pelvic organ abnormality
  • Failure to note previous cesarean history
  • Inconsistent coding across different encounters
  • Lack of clarity in the clinical narrative

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include detailed descriptions of the pelvic organ abnormalities, previous surgical history, and any complications or interventions planned.

Common Clinical Scenarios

Common scenarios include managing a patient with a history of uterine fibroids during pregnancy or monitoring a patient with pelvic organ prolapse.

Billing Considerations

Considerations include the impact of pelvic organ abnormalities on labor and delivery, as well as the need for potential surgical intervention.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancy documentation must include comprehensive assessments of the pelvic organ abnormalities and their implications for maternal and fetal health.

Common Clinical Scenarios

Complex scenarios may involve managing pregnancies complicated by uterine scarring or previous cesarean deliveries.

Billing Considerations

High-risk coding considerations include monitoring for complications such as uterine rupture or abnormal placentation.

Coding Guidelines

Inclusion Criteria

Use O34.90 When
  • According to official coding guidelines, O34
  • 90 should be used when there is a documented abnormality of the pelvic organ without further specification
  • Coders must ensure that the diagnosis is supported by clinical documentation and that the appropriate trimester is indicated

Exclusion Criteria

Do NOT use O34.90 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 in conjunction with O34.90 when managing a patient with pelvic organ abnormalities throughout pregnancy.

Documentation Requirements

Documentation must reflect the ongoing management of the pelvic organ abnormality and any interventions performed.

Specialty Considerations

Obstetricians should ensure that all aspects of care related to the pelvic organ abnormality are documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding options, but it has also introduced complexity with unspecified codes like O34.90. Coders must be diligent in ensuring that documentation supports the use of this code to avoid potential denials or audits.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding options, but it has also introduced complexity with unspecified codes like O34.90. Coders must be diligent in ensuring that documentation supports the use of this code to avoid potential denials or audits.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding options, but it has also introduced complexity with unspecified codes like O34.90. Coders must be diligent in ensuring that documentation supports the use of this code to avoid potential denials or audits.

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

When should O34.90 be used?

O34.90 should be used when there is a documented abnormality of the pelvic organ that is unspecified. It is important to ensure that the documentation supports the use of this code and that any relevant history, such as previous cesarean sections, is noted.