Quiz: Ensure Accurate ICD-10-CM 2018 Coding for Antenatal Screening and Maternal Care

Thu, Feb 22, 2018 --

Coding Updates, ICD-10

Birth defects are a leading cause of infant mortality in the U.S. In fact, about 5,500 infants in the country die each year due to birth defects.

In an effort to bring down that rate, the National Birth Defects Prevention Network (NBDPN) marked January 2018 as National Birth Defects Prevention Month. The theme for this year was Prevent to Protect. We do not know the cause of many birth defects and many birth defects cannot be prevented, but the campaign stressed the importance of preventing infection during pregnancy to reduce the probability of having a baby with a birth defect.

Did you know? Effective coding can be critical to data collected by birth defect surveillance programs. And screenings to identify potential birth defects can inform healthcare decisions and care. Take this quick quiz to ensure your antenatal screening and maternal care coding is accurate and up to date.

Question 1: Prior to Oct. 1, 2017, you used Z36 (Encounter for antenatal screening of mother) for OB screening encounters, but now you have more specific codes. Which specific ICD-10-CM encounter code should you report for antenatal screening for chromosomal anomalies?

Answer: Your code will now need to emphasize why the patient underwent the encounter for antenatal screening. So here you’ll report Z36.0 (Encounter for antenatal screening for chromosomal anomalies).

Question 2: How would you report a scenario when a pregnant patient finds out that her baby may have some chromosomal abnormalities due to increased alpha-fetoprotein (AFP) values, and she meets to talk it over with her physician?

Answer: For this scenario, you’ll report an office visit (99211-99215, Office or other outpatient visit…) along with the new code Z36.1 (Encounter for antenatal screening for raised alphafetoprotein level).

Question 3: If the pregnant patient has to undergo antenatal screening for fetal lung maturity, which new Z code would you use?

Answer: Here you’ll use the code Z36.84 (Encounter for antenatal screening for fetal lung maturity). Don’t miss that this code from Z36.8- (Other antenatal screening) requires a fifth character.

Question 4: Some pregnant patients need more maternal care due to fetal heart difficulties. How will you report such cases?

Answer: To report this condition-specific care, ICD-10-CM has introduced a new subcategory, O36.83- (Maternal care for abnormalities of the fetal heart rate or rhythm). This subcategory requires sixth and seventh characters based on trimester and fetus number.

What About You?

How did you do? How often do you report these codes in your practice? Do you like having these more specific codes?


Barnali is a medical coding and billing writer at TCI who has worked in the healthcare industry since 2009. She holds a master’s degree in English literature and a diploma in advertising and marketing. She enjoys writing about ICD-10 and Medicare compliance.

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