Concerned about decreased fetal movement? Find key information on diagnosing and documenting reduced fetal movement, including clinical guidelines, ICD-10 codes, and differential diagnoses for diminished fetal activity. This resource supports healthcare professionals in accurately assessing and managing cases of decreased fetal movement, ensuring optimal patient care and accurate medical coding for reduced fetal activity. Learn about fetal kick counts and other methods for monitoring fetal movement.
Also known as
Maternal care for other fetal problems
Covers other specified fetal complications affecting the mother.
Maternal care for known or suspected fetal abnormality
Includes maternal care for suspected or confirmed fetal abnormalities.
Supervision of normal pregnancy
Encompasses routine antenatal care and monitoring of a normal pregnancy.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the pregnancy confirmed?
Yes
Is there a documented decrease in fetal movement?
No
Do not code decreased fetal movement. Code signs/symptoms if applicable.
When to use each related code
| Description |
|---|
| Reduced fetal activity sensed by mother. |
| Absent fetal heartbeat confirmed on ultrasound. |
| Fetal growth restriction diagnosed by ultrasound. |
Coding DFM without specifying onset, duration, or other relevant clinical details can lead to claim denials and inaccurate data.
Miscoding DFM as fetal distress or vice versa can impact severity reporting and reimbursement. Accurate clinical documentation is crucial.
Insufficient documentation of maternal perception, clinical evaluation, and management of DFM can lead to coding and billing errors.
Q: What are the evidence-based best practices for evaluating decreased fetal movement in the third trimester, and how can I differentiate between normal variations and true fetal compromise?
A: Evaluating decreased fetal movement in the third trimester requires a nuanced approach that balances maternal perception with objective assessment. Begin by taking a thorough history, focusing on the onset, duration, and character of the perceived reduction in fetal activity. While maternal perception is subjective, it is a crucial initial indicator. Consider implementing a standardized fetal kick count chart to quantify fetal movements over a specific period. Alongside maternal perception, incorporate non-stress tests (NSTs), biophysical profiles (BPPs), and Doppler velocimetry as clinically indicated to assess fetal well-being objectively. Differentiating between normal variations and true fetal compromise hinges on correlating maternal perception with these objective measures. Isolated episodes of reduced movement without other concerning findings on NST, BPP, or Doppler often represent normal variations. However, persistent decreased fetal movement, especially in conjunction with abnormal test results, raises the suspicion of fetal compromise and warrants further investigation. Explore how incorporating a comprehensive assessment strategy can enhance the detection of at-risk pregnancies.
Q: When should I consider decreased fetal movement a medical emergency requiring immediate intervention, particularly in pregnancies complicated by factors like gestational diabetes or preeclampsia?
A: Decreased fetal movement should be considered a potential medical emergency requiring immediate intervention when accompanied by other concerning signs or risk factors. In the context of complicating factors like gestational diabetes or preeclampsia, the threshold for intervention should be lower. Specifically, consider immediate evaluation if decreased fetal movement is accompanied by vaginal bleeding, abdominal pain, leakage of fluid, contractions, or significant changes in maternal vital signs. In pregnancies complicated by gestational diabetes, poor glycemic control can affect fetal activity. Similarly, in preeclampsia, uteroplacental insufficiency can contribute to reduced fetal movement. In both cases, decreased fetal movement, even without other overt symptoms, should prompt immediate assessment, including NST, BPP, and Doppler studies. Learn more about risk stratification in pregnancies complicated by gestational diabetes or preeclampsia to guide appropriate management decisions.
Subjective: Patient presents with concerns of decreased fetal movement, also described as reduced fetal movement or diminished fetal activity. Onset reported as [Date/Time or Duration]. Patient reports [Number] perceived fetal movements in the past [Timeframe, e.g., hour, 12 hours, 24 hours]. She denies abdominal pain, vaginal bleeding, or leakage of fluid. Patient's gestational age is currently [Gestational Age] by [Dating Method, e.g., LMP, ultrasound]. Past obstetrical history includes [Gravida, Para]. Relevant medical history includes [List relevant medical history, e.g., gestational diabetes, hypertension]. Objective: Fetal heart tones obtained via [Method, e.g., Doppler, external fetal monitor] with a baseline heart rate of [Heart Rate] bpm. [Rhythm, e.g., regular, irregular]. [Presence or absence of accelerations/decelerations]. Uterine fundus measures [Fundal Height] cm. A non-stress test (NST) was performed and the result is [Reactive/Nonreactive]. [If nonreactive, describe further management, e.g., biophysical profile (BPP) ordered, referral to maternal-fetal medicine specialist]. Ultrasound examination reveals [Findings, e.g., normal amniotic fluid index, estimated fetal weight]. Assessment: Decreased fetal movement at [Gestational Age] weeks. Differential diagnosis includes normal variation in fetal activity, fetal sleep cycle, maternal perception, uteroplacental insufficiency, and other causes of fetal compromise. Plan: Patient counseled on the importance of fetal kick counts and instructed to return immediately for further evaluation if fetal movement continues to be diminished or absent. [Further plan based on NST and ultrasound results, e.g., repeat NST in 24 hours, BPP scheduled, induction of labor if indicated]. Patient education provided regarding fetal monitoring and warning signs. ICD-10 code O36.8991 (Other specified abnormalities of fetal heart rate and rhythm, unspecified trimester) may be applicable depending on the clinical scenario and final diagnosis. This documentation will be updated based on ongoing evaluation and results of further testing.