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v1.0.0
ICD-10 Guide
ICD-10 CodesO36.0914

O36.0914

Billable

Maternal care for other rhesus isoimmunization, first trimester (fetus 4)

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

Code Description

ICD-10 O36.0914 is a billable code used to indicate a diagnosis of maternal care for other rhesus isoimmunization, first trimester (fetus 4).

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 fetus and newborn (HDFN). In the first trimester, maternal care focuses on monitoring the fetus for signs of distress and growth restriction due to potential hemolysis. This condition can lead to complications such as anemia, jaundice, and in severe cases, fetal hydrops. Care involves regular ultrasounds to assess fetal growth and well-being, as well as maternal blood tests to monitor antibody levels. Early intervention is crucial to manage risks associated with isoimmunization, including potential intrauterine transfusions if severe anemia is detected. The management plan may also include counseling regarding the risks of subsequent pregnancies and the importance of Rh immunoglobulin administration to prevent future isoimmunization.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Understanding of maternal-fetal blood group incompatibility
  • Need for detailed monitoring of fetal growth and distress
  • Interpreting laboratory results related to antibody levels
  • Coordination of care among multiple specialties

Audit Risk Factors

  • Inadequate documentation of fetal monitoring
  • Failure to document maternal antibody testing results
  • Lack of clear care plans for high-risk pregnancies
  • Improper coding of associated conditions or complications

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 Rh isoimmunization in first trimester, monitoring for fetal growth restriction.

Billing Considerations

Ensure accurate coding of maternal and fetal conditions, and document all assessments and interventions.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, ultrasound findings, and treatment plans.

Common Clinical Scenarios

Complex cases involving multiple fetal anomalies or severe maternal conditions.

Billing Considerations

Focus on interdisciplinary communication and detailed documentation of all findings and recommendations.

Coding Guidelines

Inclusion Criteria

Use O36.0914 When
  • Follow the ICD
  • CM guidelines for obstetric coding, ensuring that the trimester of pregnancy is accurately documented and that any complications are coded appropriately

Exclusion Criteria

Do NOT use O36.0914 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76801CPT Code

Ultrasound, pregnant uterus, transabdominal, real-time with image documentation

Clinical Scenario

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

Documentation Requirements

Document the reason for the ultrasound and findings related to fetal health.

Specialty Considerations

Ensure that the ultrasound is performed by qualified personnel and that results are communicated effectively.

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 cases of rhesus isoimmunization and its complications.

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 cases of rhesus isoimmunization and its complications.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the ability to track and manage cases of rhesus isoimmunization and its complications.

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 O36.0914 accurately?

Accurate coding of O36.0914 is crucial for ensuring appropriate management of high-risk pregnancies and for facilitating proper reimbursement for the care provided. It also aids in tracking maternal and fetal outcomes related to rhesus isoimmunization.