ICD-10 Coding for Large for Gestational Age (LGA)(O36.60X0, O36.63X0)
Complete ICD-10-CM coding and documentation guide for Large for Gestational Age (LGA). Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Large for Gestational Age (LGA)
O36.60X0-O36.63X9Primary Range
Maternal care for excessive fetal growth
Primary range for coding excessive fetal growth based on trimester
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| O36.60X0 | Maternal care for excessive fetal growth, unspecified trimester | Use when excessive fetal growth is identified without specifying the trimester |
|
| O36.63X0 | Maternal care for excessive fetal growth, third trimester | Use when excessive fetal growth is identified in the third trimester |
|
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 large for gestational age
Essential facts and insights about Large for Gestational Age (LGA)
Primary ICD-10-CM Codes for large for gestational age
Decision Criteria
clinical Criteria
- EFW >90th percentile confirmed by ultrasound
Applicable To
- Estimated fetal weight >90th percentile
Excludes
- Fetal macrosomia (P08.0)
Clinical Validation Requirements
- Ultrasound-confirmed EFW >90th percentile
- Fundal height >4 cm above gestational age
Code-Specific Risks
- Incorrectly using P08.0 for LGA
Coding Notes
- Ensure documentation specifies EFW >90th percentile
O36.63X0 - Maternal care for excessive fetal growth, third trimester
Use when excessive fetal growth is identified in the third trimester
Applicable To
- Estimated fetal weight >90th percentile in third trimester
Excludes
- Fetal macrosomia (P08.0)
Clinical Validation Requirements
- Ultrasound-confirmed EFW >90th percentile in third trimester
- Fundal height >4 cm above gestational age
Coding Notes
Ensure documentation specifies EFW >90th percentile in the third trimester
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.
Uterine size-date discrepancy
O26.84-Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Large for Gestational Age (LGA) to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O36.60X0.
Impact
Clinical: Inaccurate clinical data, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Verify trimester before coding, Use trimester-specific codes
Impact
Reimbursement: Incorrect coding may lead to claim denials, Compliance: Non-compliance with ICD-10 guidelines, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Use O36.6 codes for excessive fetal growth based on trimester
Impact
Failure to sequence diabetes before LGA when related
Mitigation Strategy
Educate coders on sequencing rules
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 Large for Gestational Age (LGA), with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Large for Gestational Age (LGA)
Use these documentation templates to ensure complete and accurate documentation for Large for Gestational Age (LGA). These templates include all required elements for proper coding and billing.
Antepartum H&P
Specialty: ObstetricsRequired Elements
- Gestational Age
- EFW
- Fundal Height
- Maternal Comorbidities
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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