2025 ICD-10-CM code Z34.02
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Factors influencing health status and contact with health services - Persons encountering health services in circumstances related to reproduction Chapter 21: Factors influencing health status and contact with health services Feed
Encounter for supervision of a normal first pregnancy during the second trimester.
Modifiers are not applicable to ICD-10 codes.Modifiers are applicable to procedure codes used with Z34.02.
Medical necessity for routine prenatal care in the second trimester of pregnancy is established based on the recognized importance of monitoring the health of the mother and fetus to ensure a healthy pregnancy outcome.Absence of complications does not negate this necessity. Regular monitoring reduces the risk of complications and improves outcomes.
The clinical responsibility lies with the healthcare provider (physician, midwife, or other qualified healthcare professional) managing the pregnancy. This includes performing physical examinations, ordering and interpreting laboratory tests, performing ultrasounds, providing health education and counseling, and addressing any minor concerns.
- Chapter 21: Factors influencing health status and contact with health services
- Z30-Z39: Persons encountering health services in circumstances related to reproduction
In simple words: This code is used when a pregnant woman is seen by a doctor for a regular checkup during her first pregnancy's second trimester (weeks 14-27). The checkup is for a healthy pregnancy with no problems.
This code signifies a healthcare encounter focused on the routine monitoring and care of a woman experiencing a normal first pregnancy within the second trimester (weeks 14-27).The encounter includes assessment of the mother's health, fetal development, and the overall progress of the pregnancy.It excludes any complications or high-risk factors.
Example 1: A 25-year-old woman, at 18 weeks gestation in her first pregnancy, visits her OB/GYN for a routine prenatal visit. The visit includes a physical exam, blood pressure check, urine analysis, fetal heart rate assessment using a Doppler, and discussion of diet and exercise., A 30-year-old woman, at 22 weeks gestation in her first pregnancy, has a scheduled ultrasound appointment for fetal anatomy assessment.The ultrasound confirms normal fetal development. This visit will be coded using Z34.02 along with the appropriate ultrasound code., A 28-year-old woman at 26 weeks gestation in her first pregnancy reports mild back pain and some fatigue. Her doctor conducts a physical examination, discusses management of the symptoms, and notes the overall health of the mother and the fetus as normal.
Complete medical history of the patient; Documentation of the gestational age;Notes from the physical examination; Results of any laboratory tests or diagnostic imaging (ultrasound); Documentation of any counseling or education provided to the patient.
** This code is exempt from Present on Admission (POA) reporting requirements.
- Revenue Code: Revenue codes will vary depending on the services provided during the encounter.Examples could include codes for office visits, prenatal care, or ultrasound services.
- RVU: RVUs are not directly associated with ICD-10 codes.Reimbursement is determined by the procedure codes used in conjunction with Z34.02, and the associated RVUs for those procedures.
- Global Days: Not applicable. This is a diagnosis code, not a procedure code.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes. Fee schedules are associated with procedure codes.
- Specialties:Obstetrics and Gynecology
- Place of Service:Office, Outpatient Hospital, Birthing Center