ICD-10 Coding for Nausea and Vomiting in Pregnancy(O21.0, O21.1, O21.9)
Complete ICD-10-CM coding and documentation guide for Nausea and Vomiting in Pregnancy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Nausea and Vomiting in 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 |
|---|---|---|---|
| O21.0 | Mild hyperemesis gravidarum | Use when the patient experiences mild vomiting with no significant metabolic disturbance. |
|
| O21.1 | Hyperemesis gravidarum with metabolic disturbance | Use when there is severe vomiting with metabolic disturbances like electrolyte imbalance. |
|
| O21.9 | Unspecified vomiting of pregnancy | Use when vomiting is related to pregnancy but does not meet criteria for O21.0 or O21.1. |
|
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 nausea and vomiting in pregnancy
Essential facts and insights about Nausea and Vomiting in Pregnancy
Primary ICD-10-CM Codes for nausea and vomiting in pregnancy
Decision Criteria
clinical Criteria
- Vomiting frequency and absence of metabolic issues
Applicable To
- Mild nausea and vomiting in pregnancy
Excludes
- Non-pregnancy-related vomiting (R11)
Clinical Validation Requirements
- Weight loss <5%
- No metabolic disturbance
Code-Specific Risks
- Misclassification if metabolic disturbances are present.
Coding Notes
- Ensure documentation specifies the absence of metabolic disturbances.
O21.1 - Hyperemesis gravidarum with metabolic disturbance
Use when there is severe vomiting with metabolic disturbances like electrolyte imbalance.
Applicable To
- Severe nausea and vomiting with metabolic disturbance
Excludes
- Non-pregnancy-related vomiting (R11)
Clinical Validation Requirements
- Hypokalemia (<3.5 mEq/L)
- Ketonuria
- Weight loss >5%
Coding Notes
Document specific metabolic disturbances and treatment failures.
O21.9 - Unspecified vomiting of pregnancy
Use when vomiting is related to pregnancy but does not meet criteria for O21.0 or O21.1.
Applicable To
- Vomiting in pregnancy not otherwise specified
Excludes
- Non-pregnancy-related vomiting (R11)
Clinical Validation Requirements
- Vomiting without specific criteria for hyperemesis
Coding Notes
Ensure documentation clarifies the pregnancy-related nature of vomiting.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Nausea and Vomiting in Pregnancy 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 clinical picture, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Include lab results in documentation, Use structured templates
Impact
Reimbursement: Incorrect DRG assignment and potential claim denials., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Always verify the vomiting is related to pregnancy and use O21 codes.
Impact
Lack of documentation for metabolic disturbances in hyperemesis gravidarum cases.
Mitigation Strategy
Use structured templates and checklists to ensure all necessary details are documented.
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 Nausea and Vomiting in Pregnancy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Nausea and Vomiting in Pregnancy
Use these documentation templates to ensure complete and accurate documentation for Nausea and Vomiting in Pregnancy. These templates include all required elements for proper coding and billing.
Severe vomiting in pregnancy
Specialty: ObstetricsRequired Elements
- Vomiting frequency
- Weight loss percentage
- Metabolic disturbance evidence
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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