2025 ICD-10-CM code Z36.0
(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 antenatal screening for chromosomal anomalies.
Modifiers are not applicable to ICD-10-CM codes.
Medical necessity for antenatal screening for chromosomal anomalies is typically established based on the patient's age, family history of chromosomal abnormalities, prior pregnancies with chromosomal abnormalities, or abnormal findings on ultrasound or other prenatal tests.Specific payer requirements might vary.
The clinical responsibility lies with the obstetrician or other healthcare professional performing the antenatal screening and interpreting the results. This may include genetic counselors.
- 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 goes to the doctor for testing to check if her baby has any chromosomal problems before it's born.
This code signifies a healthcare encounter specifically for antenatal (before birth) screening to detect chromosomal abnormalities in the fetus.The screening may involve various tests, and the code is used when the primary reason for the visit is this specific screening, regardless of the test's outcome.
Example 1: A pregnant woman at 16 weeks gestation undergoes amniocentesis for chromosomal anomaly screening.The code Z36.0 is used to indicate the reason for the visit., A pregnant woman at 20 weeks gestation has a non-invasive prenatal testing (NIPT) performed, with the sole purpose of screening for chromosomal abnormalities.Z36.0 would be the appropriate code for this encounter., A pregnant patient is referred for genetic counseling following an abnormal result on an earlier screening test.The Z36.0 code would be used for the initial screening visit, with additional codes representing the genetic counseling and any further testing.
Documentation should include the type of antenatal screening performed (e.g., amniocentesis, CVS, NIPT), the gestational age at the time of screening, the results of the screening, and any subsequent actions taken based on the results.
** This code is solely for the screening encounter.If a procedure is performed during the encounter, an appropriate procedural code (e.g., CPT code) must also be reported.
- Revenue Code: Revenue codes will vary depending on the specific services provided during the encounter.
- RVU: RVUs are not applicable to ICD-10 codes.RVUs are associated with procedural codes like CPT codes, which would be used in conjunction with this diagnostic code if any procedures were performed.
- Global Days: Not applicable to ICD-10 codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10-CM codes.
- Fee Schedule: Not applicable to ICD-10-CM codes.
- Specialties:Obstetrics, Genetics, Maternal-Fetal Medicine
- Place of Service:Office, Hospital (outpatient or inpatient), Ambulatory Surgical Center