ICD-10 Coding for Fetal Growth Restriction(O36.5910)
Complete ICD-10-CM coding and documentation guide for Fetal Growth Restriction. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Fetal Growth Restriction
O36.59X0-O36.59X9Primary Range
Maternal care for poor fetal growth
This range is used for coding confirmed cases of fetal growth restriction.
Uterine size-date discrepancy
Used when there is a size-date discrepancy without confirmed FGR.
Key Information: ICD-10 code for fetal growth restriction
Essential facts and insights about Fetal Growth Restriction
Primary ICD-10-CM Code for fetal growth restriction
Decision Criteria
clinical Criteria
- EFW or AC below the 10th percentile with abnormal Doppler
coding Criteria
- Use O36.59- for confirmed FGR cases
Applicable To
- Poor fetal growth in first trimester
Excludes
- Size-date discrepancy without confirmed FGR
Clinical Validation Requirements
- EFW or AC below the 10th percentile
- Abnormal Doppler findings
Code-Specific Risks
- Incorrectly using for size-date discrepancies without confirmed FGR
Coding Notes
- Ensure documentation includes specific percentile rankings and Doppler findings.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Weeks of gestation
Z3A.XXDifferential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Size-date discrepancy
O26.84-Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Fetal Growth Restriction to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O36.5910.
Impact
Clinical: May lead to misdiagnosis or inappropriate management., Regulatory: Increases risk of audit failures., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Ensure all ultrasound reports include percentile rankings.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: May result in audit flags for incorrect coding., Data Quality: Affects the accuracy of clinical data reporting.
Mitigation Strategy
Ensure FGR is confirmed with clinical evidence before using O36.59- codes.
Impact
Lack of specific clinical evidence for FGR coding.
Mitigation Strategy
Ensure all documentation includes specific percentile and Doppler findings.
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 Growth Restriction, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Fetal Growth Restriction
Use these documentation templates to ensure complete and accurate documentation for Fetal Growth Restriction. These templates include all required elements for proper coding and billing.
FGR with abnormal Doppler findings
Specialty: ObstetricsRequired Elements
- Gestational age
- Ultrasound findings
- Doppler results
- Management plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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