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v1.0.0
ICD-10 Guide
ICD-10 CodesO36.0934

O36.0934

Billable

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

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

Code Description

ICD-10 O36.0934 is a billable code used to indicate a diagnosis of maternal care for other rhesus isoimmunization, third trimester (fetus 4).

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 Rh-positive blood cells. This condition can lead to hemolytic disease of the fetus and newborn (HDFN), which can cause severe anemia, jaundice, and even fetal distress. In the third trimester, careful surveillance is critical, especially for the fourth fetus in a pregnancy, as the risk of complications increases with each subsequent pregnancy. Clinicians must assess fetal growth, monitor for signs of fetal distress, and evaluate the need for interventions such as intrauterine transfusions or early delivery. Regular ultrasounds and non-stress tests are essential to ensure the fetus is thriving and to detect any signs of growth restriction or distress early. The management plan may also include the administration of Rh immunoglobulin to prevent further sensitization in future pregnancies.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Multiple pregnancies increase the risk of complications.
  • Need for detailed fetal monitoring and assessment.
  • Potential for severe maternal and fetal outcomes.
  • Variability in clinical presentation and management strategies.

Audit Risk Factors

  • Inadequate documentation of fetal monitoring.
  • Failure to document the rationale for interventions.
  • Misclassification of the severity of isoimmunization.
  • Lack of clear linkage between diagnosis and treatment provided.

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 patient with a history of Rh isoimmunization requiring close monitoring.

Billing Considerations

Ensure all fetal assessments are documented, including ultrasound findings and non-stress test results.

Maternal-Fetal Medicine

Documentation Requirements

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

Common Clinical Scenarios

Consultation for a patient with severe Rh isoimmunization requiring specialized care.

Billing Considerations

Focus on the management of potential complications and the need for interdisciplinary communication.

Coding Guidelines

Inclusion Criteria

Use O36.0934 When
  • Follow the official ICD
  • CM guidelines for obstetric coding, ensuring that the code reflects the trimester and specific fetal condition
  • Document all relevant clinical findings and interventions to support the use of this code

Exclusion Criteria

Do NOT use O36.0934 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 indications for 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 capture the complexity of cases like rhesus isoimmunization. This specificity aids in better patient management and resource allocation.

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 complexity of cases like rhesus isoimmunization. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the ability to capture the complexity of cases like rhesus isoimmunization. This specificity aids in better patient management and resource allocation.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of coding O36.0934 accurately?

Accurate coding of O36.0934 is crucial for ensuring appropriate management of high-risk pregnancies. It helps in tracking maternal and fetal health, justifying interventions, and ensuring proper reimbursement for the care provided.