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v1.0.0
ICD-10 Guide
ICD-10 CodesZ37.54

Z37.54

Sextuplets, all liveborn

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/12/2025

Code Description

ICD-10 Z37.54 is a billable code used to indicate a diagnosis of sextuplets, all liveborn.

Key Diagnostic Point:

Z37.54 is used to indicate that a patient has delivered sextuplets, all of whom are liveborn. This code is crucial for capturing the complexity of multiple births, which often require specialized care and monitoring. The health status of mothers delivering sextuplets can be significantly influenced by various social determinants, including socioeconomic status, access to prenatal care, and support systems. Preventive care is essential in these cases, as mothers may face increased risks of complications during pregnancy and postpartum. Screening for conditions such as gestational diabetes and hypertension is vital, as well as aftercare that includes mental health support and nutritional counseling. The use of this code helps healthcare providers track outcomes and resource utilization for high-risk pregnancies, ensuring that appropriate care is provided to both the mother and the infants.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires detailed documentation of the number of liveborn infants.
  • Involves understanding of multiple birth complications.
  • May necessitate additional codes for associated maternal conditions.
  • Requires knowledge of social determinants affecting maternal and infant health.

Audit Risk Factors

  • Inadequate documentation of the number of liveborn infants.
  • Failure to capture associated maternal health conditions.
  • Misuse of the code in non-liveborn scenarios.
  • Inconsistent coding practices across providers.

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include prenatal care visits, screenings for gestational diabetes, hypertension, and mental health assessments.

Common Clinical Scenarios

Routine checkups during pregnancy, postpartum visits, and infant well-child visits.

Billing Considerations

Consideration of social determinants such as access to care, transportation, and family support systems.

Public Health

Documentation Requirements

Population-level data collection, monitoring of health outcomes, and tracking of maternal and infant health indicators.

Common Clinical Scenarios

Epidemiological studies on multiple births and preventive health initiatives.

Billing Considerations

Focus on health disparities and access to care for families with multiple births.

Coding Guidelines

Inclusion Criteria

Use Z37.54 When
  • Z codes are used to indicate factors influencing health status and contact with health services
  • 54 should be sequenced appropriately, often following codes for any complications or conditions related to the pregnancy
  • Payer requirements may vary, so it is essential to verify coverage for multiple births and associated care

Exclusion Criteria

Do NOT use Z37.54 When
No specific exclusions found.

Related CPT Codes

99406CPT Code

Smoking cessation counseling

Clinical Scenario

Used in conjunction with Z37.54 for mothers who smoke and are advised to quit during pregnancy.

Documentation Requirements

Document counseling sessions and any referrals for smoking cessation programs.

Specialty Considerations

Primary care providers should address smoking cessation as part of comprehensive prenatal care.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding multiple births, improving data collection and health outcomes tracking for high-risk pregnancies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding multiple births, improving data collection and health outcomes tracking for high-risk pregnancies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding multiple births, improving data collection and health outcomes tracking for high-risk pregnancies.

Resources

Clinical References

  • •
    CDC Guidelines on Multiple Births

Coding & Billing References

  • •
    CDC Guidelines on Multiple Births

Frequently Asked Questions

What documentation is required for coding Z37.54?

Documentation must include the number of liveborn infants, details of the delivery, and any associated maternal health conditions. Follow-up care and screenings should also be documented to support the use of this code.