2025 ICD-10-CM code O36.8
Maternal care for other specified fetal problems.
Medical necessity should be established by documenting the specific fetal problem and the rationale for the maternal care provided. The documentation should link the care provided to the fetal problem, demonstrating why the services are necessary for the health and well-being of the mother and the fetus.
The physician is responsible for the care of the pregnant woman and the management of the specified fetal problem. This might involve monitoring, treatment, consultations, and coordination of care with other specialists, if needed.Documentation in the medical record should clearly specify the fetal problem.
- Chapter 15: Pregnancy, childbirth and the puerperium (O00-O9A)
- O36 Maternal care related to multiple gestationO36.8 Maternal care for other specified fetal problems
In simple words: This code indicates that a pregnant woman is receiving care for a specific issue affecting the fetus, that is not covered by any other code.
This code is used to indicate maternal care provided due to a specified fetal problem not classified elsewhere.This code is used on the maternal record, not the newborn's record.It indicates the reason for the maternal hospitalization or obstetric care, or for termination of pregnancy.
Example 1: A pregnant woman in her second trimester is found to have a fetus with a suspected chromosomal abnormality not otherwise specified.She is admitted for further testing and counseling. O36.8 would be used to indicate the reason for the maternal admission., A pregnant woman is receiving care because her fetus has been diagnosed with a rare congenital anomaly affecting the skeletal system, not included in codes O36.0 through O36.7. Code O36.8 would be appropriate in this scenario., A pregnant woman with a history of previous pregnancy loss is receiving specialized care and increased monitoring due to concerns about fetal growth restriction. Code O36.8 could be used if no other code from O36.0 through O36.7 specifically addresses the fetal growth issue.
Documentation should clearly specify the fetal problem prompting the maternal care.Supporting documentation may include ultrasound reports, genetic test results, specialist consultations, and other diagnostic findings.Details about the management plan and any interventions should also be documented. The specific week of gestation should be documented and reported with a Z3A code.
** Excludes1: encounter for suspected maternal and fetal conditions ruled out (Z03.7-), placental transfusion syndromes (O43.0-)Excludes2: labor and delivery complicated by fetal stress (O77.-)
- Payment Status: Active
- Specialties:Obstetrics, Maternal-Fetal Medicine, Perinatology
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Office