Concerned about decreased fetal movement in the third trimester? Learn about reduced fetal movements and diminished fetal activity, including diagnosis, monitoring, and management. This resource provides information for healthcare professionals on clinical documentation and medical coding related to decreased fetal movement, supporting accurate and comprehensive patient care. Find guidance on evaluating and documenting reduced fetal kick counts and interpreting fetal movement monitoring results.
Also known as
Other specified antepartum conditions
Covers other specified complications affecting the mother during pregnancy.
Maternal care related to the fetus
Encompasses conditions affecting the mother related to the fetus and amniotic cavity.
Disorders related to short gestation and low birth weight
Includes slow fetal growth and other conditions potentially linked to reduced movement.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the pregnancy in the third trimester?
Yes
Is there confirmed decreased fetal movement?
No
Do NOT code O36.813. Code based on trimester and clinical findings.
When to use each related code
| Description |
|---|
| Reduced fetal movement in late pregnancy. |
| Fetal distress during labor. |
| Slow fetal growth below expected. |
Coding requires specifying onset, duration, or frequency of decreased fetal movement. Lack of documentation creates audit risk.
Discrepancies between maternal report, clinical findings, and diagnostic tests can lead to coding errors and compliance issues.
Coding should capture underlying causes like placental insufficiency or fetal distress. Omitting them poses coding and CDI risks.
Q: How can I differentiate between normal and abnormal decreased fetal movement in the third trimester, and what are the recommended clinical guidelines for assessment?
A: Differentiating between normal variations and truly decreased fetal movement in the third trimester requires a thorough clinical assessment guided by established protocols. While a reduction in fetal activity can be physiological, especially closer to term as space becomes limited, it's crucial to rule out potential complications. The American College of Obstetricians and Gynecologists (ACOG) recommends various methods for assessing fetal well-being, including kick counts, non-stress tests (NSTs), biophysical profiles (BPPs), and Doppler velocimetry. Begin by asking the patient about their perception of fetal movements compared to their baseline. Specifically inquire about the frequency and strength of kicks, rolls, or flutters. A consistent pattern of reduced or absent fetal movements warrants further investigation. Consider implementing a standardized kick count protocol, educating patients on how to monitor and record fetal activity daily. If concerns persist, promptly perform an NST and BPP to evaluate fetal heart rate reactivity and overall well-being. Explore how integrating these guidelines into your practice can improve detection and management of potential fetal compromise. Learn more about interpreting NST and BPP results and managing specific scenarios related to decreased fetal movement.
Q: What are the evidence-based risk factors for decreased fetal movement in the third trimester, and how should clinicians incorporate these into patient counseling and risk stratification?
A: Decreased fetal movement in the third trimester can be associated with several risk factors, including advanced maternal age, maternal medical conditions like diabetes and hypertension, placental insufficiency, fetal growth restriction, congenital anomalies, and certain medications. Clinicians should incorporate these risk factors into patient counseling and risk stratification strategies. For example, patients with pre-existing conditions or those experiencing other pregnancy complications require closer monitoring and more frequent fetal movement assessments. Educating patients about these risk factors empowers them to recognize potential warning signs and seek timely medical attention. Clear communication about what constitutes normal versus concerning changes in fetal activity is crucial. Consider implementing a standardized risk assessment tool in your practice to identify high-risk pregnancies and tailor management accordingly. Explore how a comprehensive approach that combines patient education, risk stratification, and proactive monitoring can optimize pregnancy outcomes in cases of decreased fetal movement. Learn more about the latest research on specific risk factors and their impact on fetal well-being.
Patient presents with a chief complaint of decreased fetal movement, also documented as reduced fetal movements or diminished fetal activity, in the third trimester. Onset of decreased fetal movement was noted (date/time). Patient reports (number) fetal movements felt in the past (time period - e.g., hour, 12 hours, 24 hours). Patient denies abdominal pain, vaginal bleeding, or leakage of fluid. Gestational age is confirmed at (number) weeks by (dating method - e.g., LMP, first trimester ultrasound). Obstetric history is significant for (gravida/para, previous pregnancy complications if applicable). Current pregnancy has been complicated by (list relevant complications, e.g., gestational diabetes, pre-eclampsia, etc., or state "uncomplicated"). Physical exam reveals fundal height measuring (measurement) cm, consistent/inconsistent with gestational age. Fetal heart tones are audible via Doppler with a baseline heart rate of (number) bpm and a reactive non-stress test (NST) result documented (if performed). Assessment: Decreased fetal movement in the third trimester. Differential diagnosis includes normal variation in fetal activity, fetal sleep cycle, maternal perception, and potential fetal compromise including placental insufficiency or umbilical cord issues. Plan: Patient counseling regarding fetal kick counts and the importance of ongoing monitoring. A non-stress test (NST) was performed/will be performed with results documented. Biophysical profile (BPP) is scheduled/was performed with a score of (score if applicable). Ultrasound for fetal growth and amniotic fluid index (AFI) is planned/was performed with results documented. Continued surveillance is recommended, and patient instructed to return to the clinic/hospital for further evaluation if decreased fetal movement persists or other concerning symptoms develop. ICD-10 code O36.819 is considered for decreased fetal movements affecting fetus in the third trimester.