ICD-10 Coding for Preeclampsia(O14.90, O14.12)
Complete ICD-10-CM coding and documentation guide for Preeclampsia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Preeclampsia
O14-O15Primary Range
Hypertension complicating pregnancy, childbirth, and the puerperium
This range includes codes for preeclampsia and its complications during 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 |
|---|---|---|---|
| O14.90 | Unspecified pre-eclampsia | Use when preeclampsia is diagnosed without specification of severity or trimester. |
|
| O14.12 | Severe pre-eclampsia, second trimester | Use when severe preeclampsia is diagnosed in the second trimester. |
|
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 unspecified preeclampsia
Essential facts and insights about Preeclampsia
Primary ICD-10-CM Codes for preeclampsia
Decision Criteria
clinical Criteria
- Presence of hypertension and proteinuria after 20 weeks gestation.
Applicable To
- Postpartum preeclampsia
Excludes
- Chronic hypertension with superimposed preeclampsia (O11)
Clinical Validation Requirements
- Blood pressure ≥140/90 mmHg after 20 weeks gestation
- Proteinuria ≥300 mg/24 hours or dipstick ≥1+
Code-Specific Risks
- Misclassification if severity or trimester is known but not documented.
Coding Notes
- Ensure documentation specifies the presence of proteinuria and elevated blood pressure.
O14.12 - Severe pre-eclampsia, second trimester
Use when severe preeclampsia is diagnosed in the second trimester.
Applicable To
- Severe features such as BP ≥160/110 mmHg, thrombocytopenia
Excludes
- HELLP syndrome (O14.2-)
Clinical Validation Requirements
- Blood pressure ≥160/110 mmHg
- Platelets <100,000/microliter
Coding Notes
Document specific severe features and trimester for accurate coding.
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 Preeclampsia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O14.90.
Impact
Clinical: Impacts treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Always include trimester in clinical notes., Use templates that prompt for trimester documentation.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Use O14.2- for HELLP syndrome with specific lab findings.
Impact
Using unspecified codes when specific codes are applicable.
Mitigation Strategy
Regular training on ICD-10 updates and documentation requirements.
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 Preeclampsia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Preeclampsia
Use these documentation templates to ensure complete and accurate documentation for Preeclampsia. These templates include all required elements for proper coding and billing.
Severe preeclampsia in the second trimester
Specialty: ObstetricsRequired Elements
- Blood pressure readings
- Proteinuria levels
- Severe symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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