ICD-10 Coding for Intrauterine Growth Restriction(O36.59X, P05.9)
Complete ICD-10-CM coding and documentation guide for Intrauterine Growth Restriction. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Intrauterine Growth Restriction
O36.59XPrimary Range
Maternal care for poor fetal growth
Primary range for maternal care related to IUGR, specifying trimester.
Newborn affected by slow intrauterine growth
Used for newborns affected by IUGR, indicating growth issues post-birth.
Uterine size-date discrepancy
Used when there is a size-date discrepancy without confirmed growth pathology.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| O36.59X | Maternal care for poor fetal growth | Use when there is confirmed poor fetal growth with trimester specificity. |
|
| P05.9 | Newborn affected by slow intrauterine growth | Use for newborns with confirmed IUGR and clinical signs of malnutrition. |
|
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 IUGR
Essential facts and insights about Intrauterine Growth Restriction
Primary ICD-10-CM Codes for iugr
Decision Criteria
clinical Criteria
- EFW <3rd percentile with abnormal Doppler
coding Criteria
- Trimester specificity required
Applicable To
- Poor fetal growth
- IUGR with trimester specificity
Excludes
- Normal fetal growth
- SGA without pathology
Clinical Validation Requirements
- Estimated fetal weight <3rd percentile
- Abnormal Doppler studies
- Oligohydramnios
Code-Specific Risks
- Incorrect trimester coding
- Confusion with SGA
Coding Notes
- Ensure trimester specificity is documented.
P05.9 - Newborn affected by slow intrauterine growth
Use for newborns with confirmed IUGR and clinical signs of malnutrition.
Applicable To
- Newborn with IUGR
- Postnatal growth issues
Excludes
- Normal birth weight
- SGA without malnutrition
Clinical Validation Requirements
- Birth weight <10th percentile
- Clinical signs of malnutrition
Coding Notes
Ensure clinical signs of malnutrition are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Uterine size-date discrepancy
O26.84XDocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Intrauterine Growth Restriction to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O36.59X.
Impact
Clinical: Misrepresentation of fetal condition., Regulatory: Potential audit issues., Financial: Incorrect reimbursement rates.
Mitigation Strategy
Verify growth pathology before coding., Ensure Doppler findings are documented.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Ensure documentation specifies pathology and Doppler findings.
Impact
Incorrect trimester coding can lead to audit flags.
Mitigation Strategy
Ensure documentation clearly states the gestational age.
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 Intrauterine Growth Restriction, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Intrauterine Growth Restriction
Use these documentation templates to ensure complete and accurate documentation for Intrauterine Growth Restriction. These templates include all required elements for proper coding and billing.
Maternal-Fetal Medicine Note
Specialty: Maternal-Fetal MedicineRequired Elements
- Growth Parameters
- Doppler Findings
- Fluid Levels
- Risk Factors
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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