ICD-10 Coding for Hypertension Complicating Pregnancy(O10.01, O13.1)
Complete ICD-10-CM coding and documentation guide for Hypertension Complicating Pregnancy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hypertension Complicating Pregnancy
O10-O16Primary Range
Hypertensive disorders in pregnancy, childbirth and the puerperium
This range includes all hypertensive disorders that occur during pregnancy, childbirth, and the puerperium, including gestational and chronic hypertension.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| O10.01 | Pre-existing essential hypertension complicating pregnancy, first trimester | Use when chronic hypertension is documented before pregnancy and complicates the first trimester. |
|
| O13.1 | Gestational hypertension without significant proteinuria, first trimester | Use when hypertension develops after 20 weeks of gestation without significant 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 Hypertension Complicating Pregnancy
Primary ICD-10-CM Codes for hypertension complicating pregnancy
Decision Criteria
clinical Criteria
- Hypertension documented prior to pregnancy
documentation Criteria
- Blood pressure readings and trimester specified
Applicable To
- Chronic hypertension diagnosed before pregnancy
Excludes
- Gestational hypertension (O13.-)
Clinical Validation Requirements
- Documented history of hypertension prior to pregnancy
- Blood pressure readings consistent with hypertension
Code-Specific Risks
- Misclassification as gestational hypertension
Coding Notes
- Ensure accurate documentation of hypertension history and gestational age.
O13.1 - Gestational hypertension without significant proteinuria, first trimester
Use when hypertension develops after 20 weeks of gestation without significant proteinuria.
Applicable To
- Pregnancy-induced hypertension without proteinuria
Excludes
- Pre-existing hypertension (O10.-)
Clinical Validation Requirements
- Blood pressure readings ≥140/90 mmHg after 20 weeks of gestation
- No significant proteinuria
Coding Notes
Ensure documentation specifies no significant proteinuria.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Weeks of gestation of pregnancy
Z3A.01Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Gestational hypertension without significant proteinuria, first trimester
O13.1Pre-existing essential hypertension complicating pregnancy, first trimester
O10.01Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hypertension Complicating Pregnancy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O10.01.
Impact
Clinical: Leads to inaccurate clinical records., Regulatory: Non-compliance with coding guidelines., Financial: Potential for denied claims or incorrect reimbursement.
Mitigation Strategy
Always document gestational age with hypertension diagnosis., Use templates to ensure completeness.
Impact
Reimbursement: Incorrect coding can lead to improper reimbursement levels., Compliance: May result in compliance issues with coding standards., Data Quality: Affects the accuracy of clinical data and patient records.
Mitigation Strategy
Verify the onset of hypertension relative to pregnancy and document accordingly.
Impact
Using gestational hypertension codes for pre-existing hypertension cases.
Mitigation Strategy
Implement regular training and audits to ensure correct code usage.
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 Hypertension Complicating Pregnancy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hypertension Complicating Pregnancy
Use these documentation templates to ensure complete and accurate documentation for Hypertension Complicating Pregnancy. These templates include all required elements for proper coding and billing.
Gestational Hypertension Diagnosis
Specialty: ObstetricsRequired Elements
- Patient history
- Blood pressure readings
- Proteinuria assessment
- Gestational age
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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