Created Feb 2002
Reviewed Dec 2019


ACS 1500 Diagnosis sequencing in obstetric episodes of care states that Anti D should be coded if an obstetric patient has this administered during an admission with the diagnosis Z29.1 Prophylactic immunotherapy.

When should the code O36.0 Maternal care for rhesus isoimmunisation be assigned?

We have obstetric patients come in for antenatal visits and have Anti D administered.  Less than a week later the patient presents to hospital to deliver and at that time has another administration of Anti D.

In the second admission we have assigned O36.0 as at this stage it is known the patient will require this.

Is assigning O36.0 Maternal care for rhesus isoimmunisation correct in these cases?


No.  Based on clinical advice Anti-D is given prophylactically.  Therefore, in the case cited the correct diagnosis code to assign for the second episode of care is Z29.1 Prophylactic immunotherapy.

The diagnosis code O36.0 Maternal care for rhesus isoimmunisation should only be assigned when it is the reason for maternal care.

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