Updated ICD-10 Indications for The Performance Of A Fetal Echocardiogram
In the November 2021 issue of the American Journal of Perinatology, ICD-10 indications for Fetal Echocardiogram and Detailed First Trimester Obstetric Ultrasound were published. The abstract was authored by the SMFM Coding Committee and is based on indications published by AIUM and other national organizations. The following code revisions were made and table updated to reflect recent changes and additions to the relevant ICD-10 codes, effective 10/01/2022, which MFM subspecialists should be familiar with.
SMFM Coding Committee Task Force 2021 ICD-10 indications for the performance of a Fetal Echocardiogram (76825/76826/76827)
INDICATION
CODE
FETAL FACTORS
Arrhythmia - bradycardia (< 120 bpm), persistent
O36.83_#
Arrhythmia - heart block, suspected
O36.83_#
Arrhythmia - irregular cardiac rhythm, frequent episodes or persistent
O36.83_#
Arrhythmia - tachycardia (> 180 bpm), persistent
O36.83_#
Cardiac function abnormality, suspected
O35.BXX#
Cardiac structural anomaly, suspected
O35.BXX#
Chromosomal abnormality (invasive test or NIPT)
O35.10X#-O35.19X#
Effusions**
O35.8XX#
Hydrops fetalis
O36.2_X#
Major extracardiac anomaly (CNS)
O35.00X#-O35.09X#
Major extracardiac anomaly (non-CNS)
O35.8XX#
Nuchal translucency ≥ 3.5 mm or ≥ 99%'ile; (NT 3.0-3.4* or > 95%'ile**)
O28.3
Placenta or umbilical cord abnormalities (e.g. single umbilical artery)**
O43.19_
Systemic venous anomaly* (e.g. persistent right UV, left SVC, absent DV)
O35.8XX#
Triplet gestation with ≥ 2 monochorionic
O30.11_
Triplet gestation with ≥ 2 monoamniotic
O30.12_
Twin gestation - conjoined twins
O30.02_
Twin gestation - monochorionic-monoamniotic twins
O30.01_
Twin gestation - monochorionic-diamniotic twins
O30.03_
MATERNAL or FAMILIAL DISEASE or MATERNAL ENVIRONMENTAL EXPOSURE
Autoimmune disease with anti-SSA (or SSB**) with (or without*) a prior affected fetus
O99.891 & R76.8
Diabetes, gestational, early diagnosis†, A1
O24.410
Diabetes, gestational, early diagnosis†, A2, on oral agent
O24.415
Diabetes, gestational, early diagnosis†, A2, on insulin
O24.414
Diabetes, gestational, early diagnosis†, unspecified control
O24.419
Diabetes, pregestational, Type 1
O24.01_
Diabetes, pregestational, Type 2
O24.11_
First- (or second-*) degree relative with CHD
O35.2XX#
First- or second-degree relative with CHD-associated Mendelian inheritance disorder
O35.2XX#
In vitro fertilization, including intracytoplasmic sperm injection
O09.81_
Phenylketonuria (unknown status or periconceptional phenylalanine level > 10 mg/dL)
O99.28_ & E70.0
Rubella infection in the first trimester
O35.3XX# & B06 series
Teratogen exposure (e.g. ACE-inhibitor*, carbamazepine*, lithium*, paroxetine*, retinoid)
O35.5XX#
Teratogen exposure (e.g. anticonvulsants, NSAID, vitamin A)**
O35.5XX#
Reference-
SMFM Coding Committee Task Force: Bsat F, Fisher B, Hart B, Rad S, Esposito M, Malisch T, Jain VD Adapted from https://doi.org/10.1055/s-0041-1740004 - American Journal of Perinatology – November 2021