ICD-10 Coding for Gestational Hypertension(O13.1, O13.2)
Complete ICD-10-CM coding and documentation guide for Gestational Hypertension. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Gestational Hypertension
O13.1-O13.5Primary Range
Gestational hypertension without significant proteinuria
This range covers gestational hypertension without proteinuria, categorized by trimester and complications.
Pre-eclampsia
Used when gestational hypertension progresses to pre-eclampsia, indicated by proteinuria or severe features.
Pre-existing hypertension complicating pregnancy
Used for patients with pre-existing hypertension before 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 |
|---|---|---|---|
| O13.1 | Gestational hypertension, first trimester | Use when hypertension is documented in the first trimester without proteinuria. |
|
| O13.2 | Gestational hypertension, second trimester | Use when hypertension is documented in the second trimester without proteinuria. |
|
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 gestational hypertension
Essential facts and insights about Gestational Hypertension
Primary ICD-10-CM Codes for gestational hypertension
Decision Criteria
clinical Criteria
- BP readings and absence of proteinuria
documentation Criteria
- Specific trimester documentation
Applicable To
- High blood pressure during first trimester without proteinuria
Excludes
- Pre-eclampsia (O14.-)
Clinical Validation Requirements
- BP ≥140/90 mmHg on two occasions, 4 hours apart
- No significant proteinuria
Code-Specific Risks
- Incorrectly coding as pre-eclampsia if proteinuria is present
Coding Notes
- Ensure documentation specifies no proteinuria and confirms gestational age.
O13.2 - Gestational hypertension, second trimester
Use when hypertension is documented in the second trimester without proteinuria.
Applicable To
- High blood pressure during second trimester without proteinuria
Excludes
- Pre-eclampsia (O14.-)
Clinical Validation Requirements
- BP ≥140/90 mmHg on two occasions, 4 hours apart
- No significant proteinuria
Coding Notes
Ensure documentation specifies no proteinuria and confirms gestational age.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Gestational Hypertension to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O13.1.
Impact
Clinical: May lead to incorrect diagnosis of pre-eclampsia., Regulatory: Non-compliance with ICD-10 coding standards., Financial: Potential for incorrect billing and reimbursement.
Mitigation Strategy
Always document proteinuria test results., Use quantitative values for urine protein.
Impact
Reimbursement: Incorrect DRG assignment may affect payment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Verify gestational age using LMP or ultrasound before coding.
Impact
Incorrect trimester coding can lead to audit flags.
Mitigation Strategy
Ensure accurate documentation of gestational age.
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 Gestational Hypertension, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Gestational Hypertension
Use these documentation templates to ensure complete and accurate documentation for Gestational Hypertension. These templates include all required elements for proper coding and billing.
Gestational hypertension monitoring
Specialty: ObstetricsRequired Elements
- Trimester
- BP readings
- Proteinuria test results
- Labs
- Fetal assessment
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Gestational Hypertension? Ask your questions below.