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v1.0.0
ICD-10 Guide
ICD-10 CodesO36.0110

O36.0110

Billable

Maternal care for anti-D [Rh] antibodies, first trimester (not applicable or unspecified)

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

Code Description

ICD-10 O36.0110 is a billable code used to indicate a diagnosis of maternal care for anti-d [rh] antibodies, first trimester (not applicable or unspecified).

Key Diagnostic Point:

O36.0110 refers to maternal care provided to pregnant women who have developed anti-D (Rh) antibodies during the first trimester of pregnancy. This condition arises when an Rh-negative mother is exposed to Rh-positive blood, often from a previous pregnancy or transfusion. The presence of these antibodies can lead to hemolytic disease of the fetus and newborn (HDFN), which can cause fetal complications such as anemia, jaundice, and in severe cases, fetal distress or intrauterine growth restriction (IUGR). Monitoring and management strategies are crucial during this period to assess fetal well-being and growth, as well as to prevent potential complications. Regular ultrasounds and blood tests are typically performed to evaluate fetal health and detect any signs of distress or growth issues. The management of anti-D antibodies may involve the administration of Rh immunoglobulin (RhoGAM) to prevent further sensitization and protect future pregnancies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Understanding of immunology related to Rh incompatibility
  • Need for accurate documentation of maternal antibody status
  • Monitoring protocols for fetal growth and distress
  • Differentiation between mild and severe cases of HDFN

Audit Risk Factors

  • Inadequate documentation of maternal antibody testing
  • Failure to document fetal monitoring results
  • Misclassification of the severity of the condition
  • Lack of follow-up care documentation

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include maternal blood type, antibody screening results, and any interventions taken.

Common Clinical Scenarios

Routine prenatal visits where anti-D antibodies are identified, and monitoring for fetal growth restriction.

Billing Considerations

Ensure that all fetal assessments are documented, including ultrasound findings and any interventions.

Maternal-Fetal Medicine

Documentation Requirements

Detailed records of high-risk assessments, including fetal echocardiograms and blood flow studies.

Common Clinical Scenarios

Management of pregnancies complicated by anti-D antibodies with close monitoring for fetal anemia.

Billing Considerations

Collaboration with neonatology for potential postnatal interventions.

Coding Guidelines

Inclusion Criteria

Use O36.0110 When
  • Follow the official ICD
  • CM coding guidelines for obstetric conditions, ensuring that the code is used in conjunction with appropriate documentation of maternal and fetal health status

Exclusion Criteria

Do NOT use O36.0110 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 for patients with anti-D antibodies.

Documentation Requirements

Complete documentation of all prenatal visits, including antibody testing and fetal monitoring.

Specialty Considerations

Ensure that all relevant maternal-fetal interactions are documented.

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 those related to anti-D antibodies, improving the accuracy of data collection and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of maternal conditions, including those related to anti-D antibodies, improving the accuracy of data collection and reimbursement.

Reimbursement & Billing Impact

reimbursement.

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 anti-D antibodies during pregnancy?

Anti-D antibodies can lead to serious fetal complications if not monitored and managed properly. They can cause hemolytic disease of the newborn, which may result in anemia, jaundice, or even fetal distress. Regular monitoring and appropriate interventions are crucial.