ICD-10 Coding for Cholestasis of Pregnancy(O26.641, O26.642, O26.643, O26.649)
Complete ICD-10-CM coding and documentation guide for Cholestasis of Pregnancy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Cholestasis of Pregnancy
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| O26.641 | Intrahepatic cholestasis of pregnancy, first trimester | Use when intrahepatic cholestasis is diagnosed in the first trimester. |
|
| O26.642 | Intrahepatic cholestasis of pregnancy, second trimester | Use when intrahepatic cholestasis is diagnosed in the second trimester. |
|
| O26.643 | Intrahepatic cholestasis of pregnancy, third trimester | Use when intrahepatic cholestasis is diagnosed in the third trimester. |
|
| O26.649 | Intrahepatic cholestasis of pregnancy, unspecified trimester | Use when intrahepatic cholestasis is diagnosed but trimester is not specified. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for cholestasis of pregnancy
Essential facts and insights about Cholestasis of Pregnancy
Primary ICD-10-CM Codes for cholestasis of pregnancy
Decision Criteria
clinical Criteria
- Presence of pruritus and elevated bile acids
Applicable To
- Cholestasis in the first trimester of pregnancy
Excludes
- Other liver disorders in pregnancy
Clinical Validation Requirements
- Pruritus without rash
- Total bile acids ≥10 µmol/L
- Elevated ALT/AST
Code-Specific Risks
- Misclassification if trimester is not documented.
Coding Notes
- Ensure trimester is documented to avoid coding errors.
O26.642 - Intrahepatic cholestasis of pregnancy, second trimester
Use when intrahepatic cholestasis is diagnosed in the second trimester.
Applicable To
- Cholestasis in the second trimester of pregnancy
Excludes
- Other liver disorders in pregnancy
Clinical Validation Requirements
- Pruritus without rash
- Total bile acids ≥10 µmol/L
- Elevated ALT/AST
Coding Notes
Ensure trimester is documented to avoid coding errors.
O26.643 - Intrahepatic cholestasis of pregnancy, third trimester
Use when intrahepatic cholestasis is diagnosed in the third trimester.
Applicable To
- Cholestasis in the third trimester of pregnancy
Excludes
- Other liver disorders in pregnancy
Clinical Validation Requirements
- Pruritus without rash
- Total bile acids ≥10 µmol/L
- Elevated ALT/AST
Coding Notes
Ensure trimester is documented to avoid coding errors.
O26.649 - Intrahepatic cholestasis of pregnancy, unspecified trimester
Use when intrahepatic cholestasis is diagnosed but trimester is not specified.
Applicable To
- Cholestasis in pregnancy without specified trimester
Excludes
- Other liver disorders in pregnancy
Clinical Validation Requirements
- Pruritus without rash
- Total bile acids ≥10 µmol/L
- Elevated ALT/AST
Coding Notes
Ensure trimester is documented to avoid coding errors.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Weeks of gestation of pregnancy, less than 10 weeks
Z3A.01Weeks of gestation of pregnancy, 20 weeks
Z3A.20Weeks of gestation of pregnancy, 32 weeks
Z3A.32Weeks of gestation of pregnancy, unspecified
Z3A.00Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Cholestasis of Pregnancy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O26.641.
Impact
Clinical: May lead to inappropriate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials or reduced reimbursement.
Mitigation Strategy
Always include trimester in clinical notes., Use templates to ensure completeness.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with updated coding standards., Data Quality: Inaccurate data for clinical and research purposes.
Mitigation Strategy
Use the new O26.64- series codes with trimester specificity.
Impact
Reimbursement: May affect DRG assignment and reimbursement., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Ensure documentation specifies the trimester for accurate coding.
Impact
Failure to document trimester can lead to audit issues.
Mitigation Strategy
Ensure all documentation includes trimester information.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Cholestasis of Pregnancy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Cholestasis of Pregnancy
Use these documentation templates to ensure complete and accurate documentation for Cholestasis of Pregnancy. These templates include all required elements for proper coding and billing.
Documenting ICP in the third trimester
Specialty: ObstetricsRequired Elements
- Diagnosis of ICP
- Trimester of pregnancy
- Bile acid levels
- Liver function tests
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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