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v1.0.0
ICD-10 Guide
ICD-10 CodesO36.0913

O36.0913

Billable

Maternal care for other rhesus isoimmunization, first trimester (fetus 3)

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

Code Description

ICD-10 O36.0913 is a billable code used to indicate a diagnosis of maternal care for other rhesus isoimmunization, first trimester (fetus 3).

Key Diagnostic Point:

Maternal care for rhesus isoimmunization involves the management of a pregnant woman whose immune system has developed antibodies against the Rh factor present in the fetus's blood. This condition can lead to hemolytic disease of the newborn (HDN), which may cause fetal anemia, jaundice, and other complications. In the first trimester, the focus is on monitoring the fetus's growth and development, as well as assessing for any signs of fetal distress or growth restriction. Care may include regular ultrasounds to evaluate fetal well-being, blood tests to monitor maternal antibody levels, and potential interventions such as intrauterine transfusions if severe anemia is detected. The management of this condition is crucial to prevent adverse outcomes for both the mother and the fetus, particularly in cases where the mother has had previous pregnancies affected by Rh isoimmunization.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Understanding the nuances of Rh isoimmunization and its implications for fetal health.
  • Differentiating between various types of isoimmunization and their specific management protocols.
  • Navigating the documentation requirements for high-risk pregnancies.
  • Coordinating care among multiple specialists, including obstetricians and maternal-fetal medicine specialists.

Audit Risk Factors

  • Inadequate documentation of maternal antibody testing and results.
  • Failure to document fetal assessments and growth monitoring.
  • Misclassification of the trimester or fetal number.
  • Lack of clear treatment plans or follow-up care notes.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

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

Common Clinical Scenarios

Management of a pregnant woman with a history of Rh isoimmunization, monitoring for fetal growth restriction.

Billing Considerations

Accurate coding requires understanding the implications of Rh isoimmunization on both maternal and fetal health.

Maternal-Fetal Medicine

Documentation Requirements

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

Common Clinical Scenarios

Complex cases involving multiple pregnancies or previous adverse outcomes due to Rh isoimmunization.

Billing Considerations

High-risk pregnancies require meticulous documentation to support the complexity of care provided.

Coding Guidelines

Inclusion Criteria

Use O36.0913 When
  • Follow the official ICD
  • CM guidelines for obstetric coding, ensuring that the trimester and fetal number are accurately documented
  • Pay attention to the specific criteria for coding maternal care related to isoimmunization

Exclusion Criteria

Do NOT use O36.0913 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76801CPT Code

Ultrasound, fetal, transabdominal, real-time with image documentation

Clinical Scenario

Used for monitoring fetal growth and well-being in cases of isoimmunization.

Documentation Requirements

Document the indication for the ultrasound and findings.

Specialty Considerations

Ensure that the ultrasound is performed by qualified personnel and that results are communicated to the care team.

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 detailed tracking of maternal care for isoimmunization, which aids in better management and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including detailed tracking of maternal care for isoimmunization, which aids in better management and outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including detailed tracking of maternal care for isoimmunization, which aids in better management 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 O36.0913 accurately?

Accurate coding of O36.0913 is crucial for ensuring appropriate management of the pregnancy, facilitating necessary interventions, and supporting billing for specialized care related to rhesus isoimmunization.