2025 ICD-10-CM code O36.5
Maternal care for known or suspected poor fetal growth.
The medical necessity for this code is established by the presence of known or suspected poor fetal growth, requiring maternal care specific to this condition to optimize pregnancy outcomes.
The physician providing care for the mother due to the poor fetal growth is responsible for this code. This includes monitoring the pregnancy, ordering necessary tests, and determining the best course of treatment for both mother and fetus.
In simple words: This code indicates that a pregnant woman is receiving care because her baby is not growing as expected.
This code is used for the care of a mother during pregnancy when the fetus is known or suspected to have poor growth (intrauterine growth restriction, IUGR).This includes conditions where the fetus is not growing at the expected rate.
Example 1: A pregnant woman in her second trimester undergoes an ultrasound that reveals the fetus is measuring smaller than expected for gestational age, raising concerns about poor fetal growth.Code O36.5 is used., A pregnant woman has consistently low fundal height measurements, suggesting poor fetal growth. Additional testing confirms the suspected IUGR. Code O36.5 is used., A pregnant woman with a history of pre-eclampsia is being closely monitored for fetal growth.Ultrasound findings suggest fetal growth restriction. Code O36.5 is used.
Documentation should support the diagnosis of poor fetal growth. This may include ultrasound findings, Doppler studies, fundal height measurements, biophysical profiles, and other relevant clinical information.
- Specialties:Obstetrics, Maternal-Fetal Medicine
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital