2025 ICD-10-CM code Z34.03
(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 third trimester.
Modifiers are not typically used with this code, but always refer to the most up to date guidelines.
Medical necessity for routine prenatal care in the third trimester is established based on the need to monitor the health of the mother and fetus during this critical phase of pregnancy. This helps to ensure a healthy pregnancy and delivery, preventing complications and managing potential risks. Regular visits allow for early detection of any issues, allowing for timely intervention.
The clinical responsibility lies with the healthcare provider conducting the prenatal examination and monitoring of the pregnant patient. This includes performing physical examinations, ordering and interpreting lab tests, providing health education and counseling, and addressing any concerns of the pregnant woman.The provider must document all aspects of the prenatal visit and any interventions given during that visit.
- 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 for a doctor's visit to check on a healthy first pregnancy during the final three months (third trimester).
This ICD-10-CM code signifies an encounter for the routine supervision and monitoring of a normal first pregnancy specifically during the third trimester.It's used to classify patient visits focused on prenatal care, including assessments of maternal and fetal well-being, without any complications or high-risk factors present.The code should only be used when the pregnancy is considered normal and uncomplicated.
Example 1: A 28-year-old woman at 30 weeks gestation presents for a routine prenatal visit.The visit includes a review of symptoms, blood pressure measurement, urinalysis, fetal heart rate monitoring, and a discussion on preparing for labor and delivery. No complications are noted., A 35-year-old pregnant woman, 36 weeks pregnant, attends a scheduled prenatal appointment for weight monitoring, fetal movement checks, and blood pressure assessment. The patient has had an uncomplicated pregnancy thus far., A 25-year-old patient in her 32nd week of her first pregnancy presents for a routine visit. The physician performs a physical exam, assesses fetal growth and heart rate, and discusses birthing options and potential complications.
Thorough documentation of the prenatal visit is essential. This must include the date of the visit, gestational age, maternal vital signs (blood pressure, weight, temperature), fetal heart rate and assessment, urinalysis results (if performed), and any discussions with the patient regarding their pregnancy, labor, and delivery preparations.Any abnormalities or issues should also be fully documented.
** Ensure that the documentation clearly supports the use of this code, highlighting the absence of any complications or risk factors.Always cross-reference with other codes and guidelines for accurate billing.
- Payment Status: Active
- Specialties:Obstetrics and Gynecology
- Place of Service:Office, Clinic