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ICD-10 Guide
ICD-10 CodesO36.0911

O36.0911

Billable

Maternal care for other rhesus isoimmunization, first trimester (fetus 1)

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

Code Description

ICD-10 O36.0911 is a billable code used to indicate a diagnosis of maternal care for other rhesus isoimmunization, first trimester (fetus 1).

Key Diagnostic Point:

Rhesus isoimmunization occurs when an Rh-negative mother produces antibodies against Rh-positive fetal blood cells, which can lead to hemolytic disease of the newborn. In the first trimester, maternal care focuses on monitoring the mother and fetus for potential complications arising from this condition. Key concerns include fetal growth restriction due to anemia, fetal distress from compromised blood supply, and the risk of miscarriage or stillbirth. Regular ultrasounds and blood tests are essential to assess fetal well-being and growth patterns. The management may involve administering Rh immunoglobulin (RhIg) to prevent the formation of antibodies and close monitoring of the fetus's hemoglobin levels. Maternal care also includes counseling regarding the implications of the condition and potential interventions, such as intrauterine transfusions if severe anemia is detected. The goal is to ensure the health of both the mother and the fetus throughout the pregnancy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Understanding of maternal-fetal blood group incompatibility
  • Knowledge of monitoring protocols for fetal distress and growth restriction
  • Awareness of the implications of Rh isoimmunization on pregnancy outcomes
  • Familiarity with the use of Rh immunoglobulin and its documentation

Audit Risk Factors

  • Inadequate documentation of maternal blood type and antibody screening results
  • Failure to document fetal monitoring results and interventions
  • Misclassification of the severity of fetal distress or growth restriction
  • Lack of clear documentation regarding the administration of Rh immunoglobulin

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of maternal blood type, antibody screening, and fetal monitoring results are essential. Documentation should also include any interventions performed and their outcomes.

Common Clinical Scenarios

Routine prenatal visits with Rh-negative mothers, monitoring for fetal growth restriction, and addressing any signs of fetal distress.

Billing Considerations

Coders must ensure that all relevant maternal and fetal assessments are documented to support the use of this code.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk assessments, including ultrasound findings, fetal blood tests, and any interventions such as intrauterine transfusions.

Common Clinical Scenarios

Management of pregnancies complicated by severe Rh isoimmunization, including close monitoring and potential therapeutic interventions.

Billing Considerations

High-risk scenarios require meticulous documentation to justify the complexity of care and associated coding.

Coding Guidelines

Inclusion Criteria

Use O36.0911 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 assessments
  • The first trimester designation is crucial for accurate coding

Exclusion Criteria

Do NOT use O36.0911 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 Rh isoimmunization.

Documentation Requirements

Complete documentation of all prenatal visits, assessments, and interventions.

Specialty Considerations

Obstetricians must ensure that all aspects of care related to Rh isoimmunization 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 obstetric conditions, including those related to Rh isoimmunization, improving the accuracy of billing and the quality of care documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including those related to Rh isoimmunization, improving the accuracy of billing and the quality of care documentation.

Reimbursement & Billing Impact

billing and the quality of care documentation.

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 O36.0911?

Coding O36.0911 is crucial for identifying pregnancies complicated by Rh isoimmunization, which can lead to serious fetal complications. Accurate coding ensures appropriate management and monitoring of both the mother and fetus.