2025 ICD-10-CM code O34.43
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Maternal care related to the fetus and amniotic cavity and possible delivery problems - Maternal care for other abnormalities of cervix Chapter 15: Pregnancy, childbirth and the puerperium (O00-O9A) Feed
Maternal care for other abnormalities of the cervix during the third trimester of pregnancy.
Not applicable to ICD-10 codes. Modifiers are used with CPT and HCPCS codes.
Medical necessity for code O34.43 is established through the documentation showing the presence of a cervical abnormality requiring active medical management in the third trimester. The level of intervention and frequency of visits are determined by the severity of the condition and the patient's response to treatment.Justification needs to be supported by clinical documentation in the medical record.
The clinical responsibility for code O34.43 falls upon the obstetrician or healthcare provider managing the pregnancy. This includes diagnosing and treating any abnormalities of the cervix that arise during the third trimester.This may involve various interventions ranging from close monitoring and conservative management to more invasive procedures.
- Chapter 15: Pregnancy, childbirth and the puerperium (O00-O9A)
- O34 - Maternal care for other abnormalities of cervix
In simple words: This code is used for a mother's medical care during her pregnancy's third trimester (from 28 weeks onward) if she has any problems with her cervix (the lower part of the uterus) that aren't covered by other specific codes. The doctor's notes must clearly state the specific problem and treatments.
This ICD-10-CM code, O34.43, signifies maternal care necessitated by other specified abnormalities of the cervix occurring in the third trimester of pregnancy (defined as 28 weeks or more from the first day of the last menstrual period).The code encompasses medical management and interventions related to these cervical abnormalities, excluding those explicitly listed elsewhere within the O34-series codes.Appropriate documentation should detail the specific cervical abnormality, the trimester of pregnancy, and the interventions or care provided.
Example 1: A 35-year-old woman at 32 weeks gestation presents with cervical insufficiency and requires cervical cerclage placement. Code O34.43 is used to describe the maternal care provided for this condition., A 28-year-old woman at 36 weeks gestation is diagnosed with an ectopic pregnancy. This necessitates surgical intervention and postpartum care. O34.43 might be applicable if the ectopic pregnancy affected the cervix, but other codes would likely be used as well to fully describe the situation., A patient at 30 weeks gestation has been experiencing significant cervical changes and discomfort, resulting in hospitalization for monitoring and management.O34.43 could be used to reflect the care provided if no other O34 code is more specific.
Thorough documentation is crucial for accurate coding.The medical record should include:* Confirmation of pregnancy, the specific week of gestation, and relevant dates.* Detailed description of the cervical abnormality (e.g., type, severity).* Complete documentation of any diagnostic tests (e.g., ultrasound, physical exam findings).* Documentation of all medical interventions or treatments given (e.g., medication, procedures, follow-up care).* Supporting clinical notes justifying the medical necessity of services.
** Code O34.43 is used when there are other specified abnormalities of the cervix not otherwise classified, and those abnormalities affect the maternal care in the third trimester.Always ensure to choose the most precise and specific code available in the O34 series if a more detailed description is available.
- Revenue Code: Revenue codes will vary depending on the specific services rendered and the payer.Consult your payer's guidelines for appropriate revenue codes.
- RVU: RVUs are not directly associated with ICD-10 codes.RVUs are associated with CPT codes, which describe specific medical services or procedures.Reimbursement is based on the specific services rendered, using CPT codes, and the relevant payer's fee schedule.
- Global Days : Not applicable to ICD-10 codes.Global surgical days are relevant to CPT codes for surgical procedures.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes. Technical component modifiers apply to CPT codes for procedures.
- Fee Schedule : Not applicable to ICD-10 codes. Fee schedules are associated with CPT and HCPCS codes.
- Specialties:Obstetrics and Gynecology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office