ICD-10 Coding for Maternity(O80, O60.14X0)
Complete ICD-10-CM coding and documentation guide for Maternity. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Maternity
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| O80 | Encounter for full-term uncomplicated delivery | Use for a full-term, uncomplicated vaginal delivery. |
|
| O60.14X0 | Preterm labor with preterm delivery, third trimester | Use for preterm labor resulting in delivery before 37 weeks. |
|
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 full-term delivery
Essential facts and insights about Maternity
Primary ICD-10-CM Codes for maternity
Decision Criteria
clinical Criteria
- No complications during delivery
Applicable To
- Normal delivery
- Spontaneous vertex delivery
Clinical Validation Requirements
- Full-term pregnancy
- No complications during delivery
Code-Specific Risks
- Ensure no complications are present; otherwise, use appropriate codes.
Coding Notes
- Ensure documentation supports a full-term, uncomplicated delivery.
O60.14X0 - Preterm labor with preterm delivery, third trimester
Use for preterm labor resulting in delivery before 37 weeks.
Applicable To
- Preterm labor with preterm delivery
Excludes
- False labor (O47.-)
Clinical Validation Requirements
- Documented cervical dilation and regular contractions
- Gestational age less than 37 weeks
Coding Notes
Ensure documentation specifies preterm labor and delivery.
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.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Maternity to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O80.
Impact
Clinical: Misrepresentation of patient's obstetric history., Regulatory: Non-compliance with ICD-10 guidelines., Financial: Potential claim denials or audits.
Mitigation Strategy
Review patient's obstetric history thoroughly., Use O34.212 for current pregnancy with prior cesarean scar.
Impact
Reimbursement: Potential denial of claims for unbundled services., Compliance: Non-compliance with payer guidelines., Data Quality: Inaccurate representation of services provided.
Mitigation Strategy
Use modifier -25 for separate E/M services during global period.
Impact
Inaccurate or missing gestational age can lead to audit issues.
Mitigation Strategy
Ensure Z3A codes are used with all pregnancy-related codes.
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 Maternity, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Maternity
Use these documentation templates to ensure complete and accurate documentation for Maternity. These templates include all required elements for proper coding and billing.
Antepartum visit for gestational diabetes
Specialty: ObstetricsRequired Elements
- Chief complaint
- History of present illness
- Past medical history
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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