ICD-10 Coding for Biophysical Profile 4/8(O28.8)
Complete ICD-10-CM coding and documentation guide for Biophysical Profile 4/8. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Biophysical Profile 4/8
O28-O36Primary Range
Maternal care related to the fetus and amniotic cavity and possible delivery problems
This range includes codes for abnormal findings on antenatal screening and specific fetal conditions.
Key Information: ICD-10 code for biophysical profile 4/8
Essential facts and insights about Biophysical Profile 4/8
Primary ICD-10-CM Code for biophysical profile 4/8
Decision Criteria
clinical Criteria
- BPP score of 4/8 with specific abnormal findings
documentation Criteria
- Detailed documentation of each BPP component
Applicable To
- Abnormal biophysical profile
Excludes
- Normal antenatal screening (Z34.-)
Clinical Validation Requirements
- BPP score of 4/8
- Absence of fetal breathing movements for ≥30 seconds
- Amniotic fluid index ≤5 cm
Code-Specific Risks
- Incorrectly coding as normal screening
- Failure to document specific abnormal findings
Coding Notes
- Ensure documentation specifies each component of the BPP and any additional findings.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other specified disorders of amniotic fluid and membranes
O41.8-Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Maternal care for abnormalities in fetal heart rate or rhythm
O36.83-Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Biophysical Profile 4/8 to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O28.8.
Impact
Clinical: Potential misinterpretation of fetal health status., Regulatory: Non-compliance with documentation standards., Financial: Risk of claim denials due to insufficient documentation.
Mitigation Strategy
Use structured templates for BPP documentation., Ensure all components are scored and documented.
Impact
Reimbursement: Incorrect billing could lead to denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on fetal assessments.
Mitigation Strategy
Use CPT 76819 with 59025 for separate NST billing.
Impact
Incomplete or inaccurate documentation of BPP scores.
Mitigation Strategy
Implement structured documentation templates and regular audits.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Biophysical Profile 4/8, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Biophysical Profile 4/8
Use these documentation templates to ensure complete and accurate documentation for Biophysical Profile 4/8. These templates include all required elements for proper coding and billing.
BPP 4/8 with absent fetal breathing
Specialty: ObstetricsRequired Elements
- Fetal breathing movements
- Gross body movements
- Fetal tone
- Amniotic fluid volume
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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