ICD-10 Coding for Fetal Demise(O36.4, P95)
Complete ICD-10-CM coding and documentation guide for Fetal Demise. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Fetal Demise
O36.4Primary Range
Maternal care for intrauterine death
Primary code for documenting maternal care related to fetal demise.
Fetus and newborn affected by maternal factors and by complications of pregnancy, labor, and delivery
Used when maternal conditions affect the fetus.
Fetal death of unspecified cause
Used when the cause of fetal demise is unknown after investigation.
Congenital malformations, deformations, and chromosomal abnormalities
Used when fetal demise is due to congenital anomalies.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| O36.4 | Maternal care for intrauterine death | Use when providing maternal care related to fetal demise. |
|
| P95 | Fetal death of unspecified cause | Use when the cause of fetal demise is unknown after thorough investigation. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for fetal demise
Essential facts and insights about Fetal Demise
Primary ICD-10-CM Codes for fetal demise
Decision Criteria
clinical Criteria
- Absence of fetal heart tones confirmed by ultrasound
documentation Criteria
- Gestational age documented as 20 weeks or more
Applicable To
- Maternal care for fetal death
Excludes
- Fetal death due to congenital anomalies (Q00-Q99)
Clinical Validation Requirements
- Documented absence of fetal heart tones
- Gestational age confirmation
Code-Specific Risks
- Incorrect sequencing with maternal condition codes
Coding Notes
- Ensure accurate documentation of gestational age and absence of fetal heart tones.
P95 - Fetal death of unspecified cause
Use when the cause of fetal demise is unknown after thorough investigation.
Applicable To
- Stillbirth of unknown cause
Excludes
- Fetal death due to specific conditions (P00-P04, Q00-Q99)
Clinical Validation Requirements
- Negative autopsy report
- Normal karyotype
Coding Notes
Ensure all possible causes have been ruled out before using P95.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Weeks of gestation
Z3A.XXDocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Fetal Demise to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O36.4.
Impact
Clinical: Misclassification of fetal demise cases., Regulatory: Non-compliance with reporting standards., Financial: Potential claim denials due to incorrect coding.
Mitigation Strategy
Verify gestational age with ultrasound, Cross-check with LMP date
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data for fetal demise causes.
Mitigation Strategy
Use the specific anomaly code (e.g., Q00.0 for anencephaly).
Impact
Inaccurate documentation can lead to audit findings.
Mitigation Strategy
Ensure all gestational ages are verified and documented.
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 Fetal Demise, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Fetal Demise
Use these documentation templates to ensure complete and accurate documentation for Fetal Demise. These templates include all required elements for proper coding and billing.
24-week IUFD with placental insufficiency
Specialty: ObstetricsRequired Elements
- Gestational age
- Fetal heart tones
- Placental pathology
- Karyotype results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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