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v1.0.0
ICD-10 Guide
ICD-10 CodesO36.0933

O36.0933

Billable

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

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

Code Description

ICD-10 O36.0933 is a billable code used to indicate a diagnosis of maternal care for other rhesus isoimmunization, third trimester (fetus 3).

Key Diagnostic Point:

Maternal care for rhesus isoimmunization involves monitoring and managing the health of the mother and fetus when the mother has developed antibodies against the Rh factor, which can lead to hemolytic disease of the newborn. In the third trimester, careful assessment is crucial as the fetus may experience complications such as fetal growth restriction, fetal distress, or even hydrops fetalis. The management may include serial ultrasounds to monitor fetal growth and well-being, non-stress tests to assess fetal heart rate patterns, and potential interventions such as intrauterine transfusions if severe anemia is detected. The healthcare provider must document maternal blood type, antibody screening results, and any interventions performed to ensure appropriate care and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for accurate documentation of maternal blood type and antibody status.
  • Monitoring of fetal well-being and growth parameters.
  • Potential for multiple interventions based on fetal condition.
  • Differentiation from other isoimmunization types and related complications.

Audit Risk Factors

  • Inadequate documentation of maternal blood type and Rh status.
  • Failure to document fetal monitoring results.
  • Misclassification of the type of isoimmunization.
  • Lack of clarity in the documentation of interventions performed.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include maternal blood type, antibody screening results, and detailed fetal monitoring records.

Common Clinical Scenarios

Management of a pregnant woman with a history of Rh isoimmunization presenting for routine prenatal care in the third trimester.

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

High-risk pregnancy documentation must include detailed ultrasound findings, fetal heart rate monitoring, and any interventions performed.

Common Clinical Scenarios

A patient with Rh isoimmunization requiring close monitoring due to signs of fetal distress or growth restriction.

Billing Considerations

High-risk scenarios may necessitate additional codes for complications or interventions, requiring careful review of documentation.

Coding Guidelines

Inclusion Criteria

Use O36.0933 When
  • Coders should follow the official ICD
  • CM guidelines for obstetric coding, ensuring that all relevant maternal and fetal conditions are documented and coded appropriately, particularly in high
  • risk scenarios

Exclusion Criteria

Do NOT use O36.0933 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76817CPT Code

Ultrasound, fetal biophysical profile

Clinical Scenario

Used to assess fetal well-being in cases of Rh isoimmunization.

Documentation Requirements

Documentation must include indications for the ultrasound and findings.

Specialty Considerations

Obstetricians should ensure that the ultrasound report is detailed and correlates with the diagnosis.

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 capture the nuances of maternal-fetal interactions, particularly in cases of isoimmunization.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the ability to capture the nuances of maternal-fetal interactions, particularly in cases of isoimmunization.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the ability to capture the nuances of maternal-fetal interactions, particularly in cases of isoimmunization.

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 O36.0933 accurately?

Accurate coding of O36.0933 is crucial for ensuring appropriate management of Rh isoimmunization, which can have serious implications for fetal health. It also impacts reimbursement and quality of care metrics.