2025 ICD-10-CM code O34.42
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Obstetrics - Maternal care related to the fetus and amniotic cavity and possible delivery problems Chapter XV: Pregnancy, childbirth and the puerperium (O00-O99) Feed
Maternal care for other abnormalities of the cervix during the second trimester of pregnancy.
Modifiers may apply depending on the circumstances of the service provided.Consult your payer's guidelines for specific requirements.
Medical necessity will depend on the severity of the cervical abnormality and its potential impact on the pregnancy.Documentation must clearly demonstrate the need for intervention to preserve the pregnancy or to manage a significant condition that is affecting the mother's health.
The clinical responsibility for this code falls under the obstetrician or other qualified healthcare professional managing the pregnancy.
- Chapter XV: Pregnancy, childbirth and the puerperium (O00-O99)
- O30-O48 (Maternal care related to the fetus and amniotic cavity and possible delivery problems)
In simple words: This code describes medical care a mother receives for a cervix problem during the middle part of her pregnancy (weeks 14-27).This might include treatment, a hospital stay, or a special delivery method like a C-section.
This code is used for maternal care related to other specified abnormalities of the cervix that occur during the second trimester of pregnancy (14 weeks 0 days to less than 28 weeks 0 days).It encompasses situations where the cervical condition necessitates medical attention, hospitalization, or impacts the delivery method (e.g., Cesarean section). The code should be used when the cervical abnormality is the primary reason for the obstetric care provided to the mother.If an obstructed labor is also present, code that condition (O65.5) first.
Example 1: A 22-year-old pregnant woman at 20 weeks gestation presents with cervical incompetence. She undergoes a cerclage procedure to prevent premature delivery., A 35-year-old pregnant woman at 25 weeks gestation presents with cervical insufficiency. She receives conservative management including bed rest and close monitoring, along with prophylactic antibiotics., A 28-year-old woman at 18 weeks gestation is diagnosed with an ectropion causing significant bleeding and discomfort.She undergoes electrocautery.
Detailed documentation should include the gestational age, clinical findings related to the cervical abnormality (e.g., physical exam, imaging results), specific treatment rendered, and the clinical rationale for the provided care.Progress notes should adequately reflect the condition's progression, and any complications.
** Always refer to the most current ICD-10-CM coding guidelines and payer specific instructions for accurate coding and reimbursement. This information is for guidance only and should not be considered exhaustive.
- Revenue Code: Revenue codes will vary depending on the specific services provided.Consult your payer's guidelines.
- RVU: RVUs will vary based on the services rendered and the location of service. Refer to CMS guidelines and your specific payer's fee schedule.
- Global Days : The global period will depend on the specific services and procedures performed.Refer to CPT guidelines for details regarding global surgery.
- Payment Status: Active
- Modifier TC rule: A TC modifier may be applicable based on the services rendered and the involvement of various healthcare professionals. Refer to payer guidelines.
- Fee Schedule : Historical fee schedule data is not available in the provided text. Consult fee schedules for relevant payers.
- Specialties:Obstetrics and Gynecology
- Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center