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v1.0.0
ICD-10 Guide
ICD-10 CodesO36.0935

O36.0935

Billable

Maternal care for other rhesus isoimmunization, third trimester (fetus 5)

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

Code Description

ICD-10 O36.0935 is a billable code used to indicate a diagnosis of maternal care for other rhesus isoimmunization, third trimester (fetus 5).

Key Diagnostic Point:

Maternal care for rhesus isoimmunization involves the management of a condition where the mother's immune system produces antibodies against the Rh factor present in the fetus's blood. This condition can lead to hemolytic disease of the newborn, which may result in fetal anemia, jaundice, and other complications. In the third trimester, careful monitoring is crucial as the fetus may experience growth restriction due to anemia or other related issues. The healthcare provider must assess fetal well-being through ultrasound evaluations and non-stress tests to monitor for signs of fetal distress. Management may include interventions such as intrauterine transfusions if severe anemia is detected. The complexity of care increases with the number of fetuses involved, as in this case with fetus 5, necessitating a multidisciplinary approach to ensure optimal outcomes for both mother and child.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Multiple gestation increases monitoring requirements.
  • Need for specialized testing and interventions.
  • Potential for rapid changes in fetal condition.
  • Coordination among multiple healthcare providers.

Audit Risk Factors

  • Inadequate documentation of fetal monitoring.
  • Failure to document interventions performed.
  • Misclassification of isoimmunization severity.
  • Omission of maternal health status updates.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of maternal and fetal assessments, including ultrasound findings and laboratory results.

Common Clinical Scenarios

Management of isoimmunization in singleton and multiple pregnancies, monitoring for fetal growth restriction.

Billing Considerations

Accurate coding requires understanding of the implications of isoimmunization on fetal health and the need for potential interventions.

Maternal-Fetal Medicine

Documentation Requirements

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

Common Clinical Scenarios

Complex cases involving multiple fetuses with varying degrees of isoimmunization.

Billing Considerations

Focus on advanced diagnostic techniques and interventions, such as fetal blood sampling and transfusions.

Coding Guidelines

Inclusion Criteria

Use O36.0935 When
  • Follow official ICD
  • 10 guidelines for obstetric coding, ensuring accurate documentation of maternal and fetal conditions, and adherence to pregnancy
  • specific criteria

Exclusion Criteria

Do NOT use O36.0935 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 findings related to fetal size and any abnormalities.

Specialty Considerations

Obstetricians should ensure that ultrasound reports are detailed and correlate with clinical findings.

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 accuracy of maternal and fetal health records and facilitating better care management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the accuracy of maternal and fetal health records and facilitating better care management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the accuracy of maternal and fetal health records and facilitating better care management.

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 O36.0935 accurately?

Accurate coding of O36.0935 is crucial for ensuring appropriate care management for the mother and fetus, as it reflects the complexity of the case and the need for specialized monitoring and interventions.