2025 ICD-10-CM code O26.853
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Maternal disorders - Other maternal disorders predominantly related to pregnancy Pregnancy, childbirth and the puerperium (O00-O9A) Feed
Spotting complicating pregnancy during the third trimester.
No modifiers typically apply to ICD-10 codes.
Medical necessity for evaluation of spotting in late pregnancy is based on the potential for serious underlying conditions threatening the health of both the mother and the fetus.Prompt investigation is crucial to identify and manage these risks.
The clinical responsibility for managing a patient with O26.853 rests with the obstetrician/gynecologist. This entails a comprehensive assessment to identify the cause of the bleeding (e.g., placental abruption, placenta previa, or other conditions), monitoring the maternal and fetal well-being, and providing appropriate treatment.
- Pregnancy, childbirth and the puerperium (O00-O9A)
- O26.853 falls under the broader category of O26 (Other specified disorders of the placenta and umbilical cord), specifically other specified disorders of the placenta and umbilical cord during the third trimester of pregnancy, which itself is part of the larger chapter O00-O9A (Pregnancy, childbirth, and the puerperium).
In simple words: This code describes light bleeding during the final stage of pregnancy (after 28 weeks).It's important to see a doctor if you have any bleeding during pregnancy as it could indicate a problem.
This code signifies spotting (light vaginal bleeding) that occurs during the third trimester of pregnancy (28 weeks 0 days until delivery).It is a complication of pregnancy and requires further investigation to determine the underlying cause, which may range from benign to serious conditions impacting the mother and/or fetus.This code should only be used on the maternal record.
Example 1: A 35-year-old woman at 32 weeks gestation presents to the emergency department with light vaginal bleeding.The patient reports no pain or contractions.The physician orders an ultrasound, which reveals no evidence of placenta previa or abruption.The patient is monitored for several hours and discharged with instructions to report any changes in bleeding., A 28-year-old patient at 36 weeks gestation experiences light spotting after a routine vaginal exam.The physician determines that the spotting is minimal and related to the exam and reassures the patient. No additional workup is deemed necessary., A 40-year-old woman at 38 weeks gestation has a significant amount of vaginal bleeding. The physician determines the diagnosis as placental abruption. The patient is hospitalized immediately, and a cesarean delivery is performed to ensure the safety of both the mother and the baby. Codes for placental abruption and cesarean delivery would also be assigned.
Detailed patient history including onset, duration, amount, and color of the bleeding; presence of other symptoms (pain, contractions, etc.); results of any relevant investigations (e.g., ultrasound, blood tests); physician’s assessment and plan of care; gestational age.
** This code should only be used for light bleeding (spotting).Heavier bleeding should be coded differently based on the underlying cause. Always document the clinical findings to support the code selection.This information is current as of December 3, 2024.
- Revenue Code: Revenue codes will vary depending on the services rendered.Examples include codes associated with prenatal visits, ultrasound examinations, or hospitalization.
- RVU: RVUs are not directly assigned to ICD-10 codes.The RVUs will depend on the services provided by healthcare professionals to evaluate and manage the spotting.
- Global Days : Not applicable to ICD-10 codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule : Not applicable to ICD-10 codes.
- Specialties:Obstetrics and Gynecology
- Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center, Emergency Room