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v1.0.0
ICD-10 Guide
ICD-10 CodesO36.0192

O36.0192

Billable

Maternal care for anti-D [Rh] antibodies, unspecified trimester (fetus 2)

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

Code Description

ICD-10 O36.0192 is a billable code used to indicate a diagnosis of maternal care for anti-d [rh] antibodies, unspecified trimester (fetus 2).

Key Diagnostic Point:

Maternal care for anti-D [Rh] antibodies is crucial in managing pregnancies where the mother has developed antibodies against Rh-positive blood. This condition can lead to hemolytic disease of the fetus and newborn (HDFN), which can cause serious complications such as fetal growth restriction, fetal distress, and even stillbirth. The management of this condition involves careful monitoring of the fetus through ultrasound assessments to evaluate growth and well-being, as well as maternal blood tests to assess antibody levels. In cases where fetal distress is detected, interventions may include early delivery or intrauterine transfusions. The unspecified trimester designation indicates that the care provided could occur at any point during the pregnancy, necessitating ongoing surveillance and potential interventions to ensure the health of both the mother and the fetus.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for accurate trimester specification
  • Monitoring for fetal growth restriction
  • Assessment of fetal distress indicators
  • Coordination of care among multiple specialists

Audit Risk Factors

  • Inadequate documentation of maternal antibody testing
  • Failure to document fetal monitoring results
  • Misclassification of trimester
  • Lack of coordination notes among specialists

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of maternal health, fetal assessments, and any interventions performed.

Common Clinical Scenarios

Routine monitoring of Rh-negative mothers, management of fetal growth restriction, and addressing fetal distress.

Billing Considerations

Ensure accurate documentation of all maternal and fetal assessments, including ultrasound findings and laboratory results.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including maternal history and fetal monitoring.

Common Clinical Scenarios

Management of pregnancies complicated by Rh incompatibility, including intrauterine transfusions.

Billing Considerations

Focus on detailed tracking of fetal development and maternal antibody levels, as well as interdisciplinary communication.

Coding Guidelines

Inclusion Criteria

Use O36.0192 When
  • Follow the official ICD
  • CM guidelines for obstetric coding, ensuring that the trimester is documented and that any related fetal conditions are also coded appropriately
  • The use of additional codes for fetal growth restriction or distress may be necessary

Exclusion Criteria

Do NOT use O36.0192 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76801CPT Code

Ultrasound, pregnant uterus, transabdominal

Clinical Scenario

Used for routine monitoring of fetal growth and well-being in pregnancies complicated by anti-D antibodies.

Documentation Requirements

Document the reason for the ultrasound and findings related to fetal growth and distress.

Specialty Considerations

Obstetricians should ensure that ultrasound reports are detailed and correlate with maternal antibody levels.

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, improving the ability to track and manage complications such as those associated with anti-D antibodies. This specificity aids in better patient care and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the ability to track and manage complications such as those associated with anti-D antibodies. This specificity aids in better patient care and outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the ability to track and manage complications such as those associated with anti-D antibodies. This specificity aids in better patient care and outcomes.

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 O36.0192?

Coding O36.0192 is essential for tracking pregnancies complicated by anti-D antibodies, which can lead to serious fetal complications. Accurate coding ensures that appropriate care is provided and that healthcare providers are reimbursed for the services rendered.