ICD-10 Coding for Hyperemesis Gravidarum(O21.0, O21.1)
Complete ICD-10-CM coding and documentation guide for Hyperemesis Gravidarum. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hyperemesis Gravidarum
O21.0-O21.9Primary Range
Excessive vomiting in pregnancy
This range includes codes specific to hyperemesis gravidarum, differentiating mild cases from those with metabolic disturbances.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| O21.0 | Mild hyperemesis gravidarum | Use when symptoms start before 20 weeks without metabolic disturbance. |
|
| O21.1 | Hyperemesis gravidarum with metabolic disturbance | Use when metabolic disturbances are documented. |
|
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 hyperemesis gravidarum
Essential facts and insights about Hyperemesis Gravidarum
Primary ICD-10-CM Codes for hyperemesis gravidarum
Decision Criteria
clinical Criteria
- Vomiting ≥3 times/day with 5-9% weight loss
coding Criteria
- Symptoms before 20 weeks without metabolic disturbance
Applicable To
- Persistent vomiting before 20 weeks gestation
Excludes
- Hyperemesis gravidarum with metabolic disturbance (O21.1)
Clinical Validation Requirements
- Vomiting ≥3 times/day
- Weight loss 5-9% from pre-pregnancy weight
- Ketonuria 1+ to 2+
Code-Specific Risks
- Misclassification if metabolic disturbance is present
Coding Notes
- Ensure documentation specifies vomiting frequency and weight loss percentage.
O21.1 - Hyperemesis gravidarum with metabolic disturbance
Use when metabolic disturbances are documented.
Applicable To
- Hyperemesis with electrolyte imbalance
Excludes
- Mild hyperemesis gravidarum (O21.0)
Clinical Validation Requirements
- Weight loss ≥10%
- Hypokalemia (K+ <3.0 mmol/L)
- Metabolic alkalosis (HCO3- >30 mmol/L)
Coding Notes
Ensure metabolic disturbances are clearly documented.
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 Hyperemesis Gravidarum to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O21.0.
Impact
Clinical: Inaccurate assessment of pregnancy-related conditions, Regulatory: Non-compliance with coding standards, Financial: Potential loss of reimbursement
Mitigation Strategy
Always include Z3A.XX code, Verify gestational age in clinical notes
Impact
Reimbursement: Incorrect coding may lead to lower reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use O21.0 or O21.1 based on clinical documentation.
Impact
Failure to document metabolic disturbances can lead to audit flags.
Mitigation Strategy
Ensure all lab results are included in the patient record.
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 Hyperemesis Gravidarum, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hyperemesis Gravidarum
Use these documentation templates to ensure complete and accurate documentation for Hyperemesis Gravidarum. These templates include all required elements for proper coding and billing.
Hyperemesis Gravidarum Assessment
Specialty: ObstetricsRequired Elements
- Gestational age
- Vomiting frequency
- Weight tracking
- Failed therapies
- Ketonuria
- Electrolytes
- Exclusion of alternatives
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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