Understanding the ICD-10 diagnosis code O28.8 is crucial for medical coding related to pregnancy and antenatal care. This code, titled “Other abnormal findings on antenatal screening of mother,” is used when healthcare providers discover unusual results during routine prenatal screenings that aren’t covered by more specific codes.
What is ICD-10 Code O28.8?
ICD-10-CM code O28.8 is a billable and specific code within the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) system. This code is used to designate a diagnosis for reimbursement purposes and is applicable to maternity patients aged 12-55 years and female patients in general. The 2025 edition of ICD-10-CM O28.8 became effective on October 1, 2024, with no changes from previous years going back to its introduction in 2016. It’s important to note that while this is the American ICD-10-CM version, international versions may have slight variations.
Coding Rules and Application of O28.8
Several coding rules govern the appropriate use of O28.8. As mentioned, it is specifically for maternity patients in the 12-55 age range and applies to female patients. The code falls under the chapter for Pregnancy, Childbirth, and the Puerperium (O00-O9A) and specifically within the section for antenatal screening of mother (O28).
Within the ICD-10-CM system, O28.8 is associated with annotation back-references. These references point to other codes that may contain important annotations relevant to O28.8. These annotations can include:
- Applicable To annotations
- Code Also annotations
- Code First annotations
- Excludes1 annotations
- Excludes2 annotations
- Includes annotations
- Note annotations
- Use Additional annotations
These annotations provide further guidance and context when using O28.8, ensuring accurate and comprehensive coding.
Diagnostic Related Group (DRG)
ICD-10-CM code O28.8 is categorized within Diagnostic Related Group(s) (MS-DRG v42.0). DRGs are used to classify hospital cases and estimate resource consumption, particularly for inpatient care. This grouping helps in understanding the broader clinical and financial context of diagnoses coded with O28.8.
Code History and Updates
The code O28.8 has been stable since its introduction into the ICD-10-CM system:
- 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
- 2017 – 2025: No changes
This consistent history indicates a well-established and consistently applied code within the medical coding framework.
Importance for Reimbursement
For healthcare providers and billing professionals, it’s essential to use ICD-10-CM codes accurately for reimbursement claims. Claims with a date of service on or after October 1, 2015, require the use of ICD-10-CM codes, including O28.8 when it is the most appropriate code to describe the diagnosis.
While the term “icd-10 diagnosis code for bpp 4/8” might lead some to search for a direct code related to Biophysical Profile (BPP) scores, it’s important to understand that ICD-10-CM codes are designed to be comprehensive but not always granular to every specific test result. A BPP score of 4/8, indicating potential fetal compromise, would likely be considered an abnormal finding on antenatal screening. Depending on the specific clinical context and what further investigations reveal, and if it does not fall under more specific categories like abnormal ultrasonic findings (O28.3), O28.8 could be considered as a diagnosis code to capture this type of “other abnormal finding.” However, accurate coding always requires a complete review of the patient’s medical record and clinical circumstances.
In conclusion, ICD-10 code O28.8 serves as a valuable tool for classifying and coding “Other abnormal findings on antenatal screening of mother.” It is crucial for accurate medical documentation, billing, and understanding maternal health within the ICD-10-CM framework.
