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v1.0.0
ICD-10 Guide
ICD-10 CodesO36.0111

O36.0111

Billable

Maternal care for anti-D [Rh] antibodies, first trimester (fetus 1)

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

Code Description

ICD-10 O36.0111 is a billable code used to indicate a diagnosis of maternal care for anti-d [rh] antibodies, first trimester (fetus 1).

Key Diagnostic Point:

Maternal care for anti-D [Rh] antibodies is critical during the first trimester of pregnancy, particularly for the first fetus. This condition arises when an Rh-negative mother is exposed to Rh-positive blood, leading to the production of anti-D antibodies. These antibodies can cross the placenta and potentially cause hemolytic disease in the fetus, resulting in complications such as fetal growth restriction, fetal distress, and even fetal demise. Close monitoring of the fetus is essential, including regular ultrasounds to assess growth and well-being, as well as non-stress tests to evaluate fetal heart rate patterns. Maternal care may involve administering Rh immunoglobulin (RhoGAM) to prevent antibody formation and mitigate risks to the fetus. The management of this condition requires a multidisciplinary approach, including obstetricians and maternal-fetal medicine specialists, to ensure optimal outcomes for both mother and child.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of immunology related to Rh factor incompatibility.
  • Involves monitoring for fetal complications such as growth restriction and distress.
  • Documentation must specify trimester and fetus number accurately.
  • Coordination of care among multiple specialties may be necessary.

Audit Risk Factors

  • Inadequate documentation of maternal antibody status.
  • Failure to document fetal monitoring results.
  • Incorrect coding of trimester or fetus number.
  • Lack of clarity on the management plan for anti-D antibodies.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of maternal blood type, antibody screening results, and any interventions such as RhoGAM administration.

Common Clinical Scenarios

Routine prenatal visits, management of Rh incompatibility, and monitoring for fetal growth issues.

Billing Considerations

Ensure accurate tracking of fetal development and maternal health status.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive assessments of fetal well-being, including ultrasound findings and non-stress test results.

Common Clinical Scenarios

High-risk pregnancies with Rh incompatibility, management of fetal growth restriction, and planning for delivery.

Billing Considerations

Focus on advanced monitoring techniques and potential interventions.

Coding Guidelines

Inclusion Criteria

Use O36.0111 When
  • Follow official ICD
  • 10 guidelines for obstetric coding, ensuring that the trimester and fetus number are accurately recorded
  • Documentation should reflect the clinical significance of anti
  • D antibodies and any interventions performed

Exclusion Criteria

Do NOT use O36.0111 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

36415CPT Code

Blood typing, Rh factor

Clinical Scenario

Used during initial prenatal visits to determine maternal blood type and Rh status.

Documentation Requirements

Document the results of blood typing and any follow-up care.

Specialty Considerations

Obstetricians should ensure that Rh status is monitored throughout pregnancy.

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 related to Rh incompatibility, improving the accuracy of data collection and patient care management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of maternal conditions related to Rh incompatibility, improving the accuracy of data collection and patient care management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of maternal conditions related to Rh incompatibility, improving the accuracy of data collection and patient care management.

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 complications for the fetus, including hemolytic disease. It is crucial to monitor the mother and fetus closely to manage any potential risks.