ICD-10 Coding for Hypertension in Pregnancy(O10, O11, O13, O14)
Complete ICD-10-CM coding and documentation guide for Hypertension in Pregnancy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hypertension in Pregnancy
O10-O16Primary Range
Hypertensive disorders in pregnancy, childbirth, and the puerperium
This range includes all hypertensive conditions related to pregnancy, including pre-existing and gestational hypertension, preeclampsia, and eclampsia.
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 | Pre-existing hypertension complicating pregnancy, childbirth and the puerperium | Use when hypertension is diagnosed before pregnancy or before 20 weeks of gestation. |
|
| O11 | Pre-existing hypertension with preeclampsia | Use when preeclampsia develops in a patient with pre-existing hypertension. |
|
| O13 | Gestational hypertension without significant proteinuria | Use when hypertension develops after 20 weeks of gestation without proteinuria. |
|
| O14 | Preeclampsia | Use when hypertension is accompanied by 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 hypertension in pregnancy
Essential facts and insights about Hypertension in Pregnancy
Primary ICD-10-CM Codes for hypertension in pregnancy
Decision Criteria
clinical Criteria
- Hypertension diagnosed before 20 weeks gestation or pre-pregnancy
Applicable To
- Chronic hypertension diagnosed before pregnancy
Excludes
- Gestational hypertension (O13)
Clinical Validation Requirements
- Hypertension documented before 20 weeks of gestation
- Previous medical records indicating hypertension
Code-Specific Risks
- Misclassification as gestational hypertension
Coding Notes
- Ensure documentation specifies the timing of hypertension diagnosis relative to pregnancy.
O11 - Pre-existing hypertension with preeclampsia
Use when preeclampsia develops in a patient with pre-existing hypertension.
Applicable To
- Superimposed preeclampsia on chronic hypertension
Excludes
- Gestational hypertension with preeclampsia (O14)
Clinical Validation Requirements
- Pre-existing hypertension with new onset proteinuria ≥300mg/24h
Coding Notes
Ensure proteinuria and hypertension are documented together.
O13 - Gestational hypertension without significant proteinuria
Use when hypertension develops after 20 weeks of gestation without proteinuria.
Applicable To
- Hypertension developing after 20 weeks of gestation
Excludes
- Preeclampsia (O14)
Clinical Validation Requirements
- Blood pressure readings ≥140/90 mmHg after 20 weeks gestation
Coding Notes
Ensure documentation specifies no significant proteinuria.
O14 - Preeclampsia
Use when hypertension is accompanied by significant proteinuria.
Applicable To
- Hypertension with proteinuria ≥300mg/24h
Excludes
- Eclampsia (O15)
Clinical Validation Requirements
- Blood pressure readings ≥140/90 mmHg with proteinuria ≥300mg/24h
Coding Notes
Ensure both hypertension and proteinuria are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hypertension in Pregnancy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O10.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to insufficient documentation.
Mitigation Strategy
Use specific terms like 'pre-existing hypertension' or 'gestational hypertension'., Ensure documentation includes timing and type of hypertension.
Impact
Reimbursement: Incorrect DRG assignment may affect reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient care.
Mitigation Strategy
Verify the timing of hypertension onset relative to pregnancy.
Impact
Reimbursement: Potential underpayment due to incomplete coding., Compliance: Failure to meet coding standards., Data Quality: Incomplete clinical picture in patient records.
Mitigation Strategy
Include additional codes for hypertensive heart disease if present.
Impact
Inadequate documentation of hypertension type and timing.
Mitigation Strategy
Implement standardized templates for documenting hypertensive disorders.
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 in Pregnancy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hypertension in Pregnancy
Use these documentation templates to ensure complete and accurate documentation for Hypertension in Pregnancy. These templates include all required elements for proper coding and billing.
Chronic Hypertension with Superimposed Preeclampsia
Specialty: ObstetricsRequired Elements
- Patient demographics
- Hypertension history
- BP trends
- Proteinuria levels
- Medication adjustments
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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