ICD-10 Coding for Pregnancy Complicated by Polycystic Ovary Syndrome(O99.891, E28.2)
Complete ICD-10-CM coding and documentation guide for Pregnancy Complicated by Polycystic Ovary Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pregnancy Complicated by Polycystic Ovary Syndrome
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| O99.891 | Other specified diseases and conditions complicating pregnancy, childbirth and the puerperium | Use when PCOS directly impacts pregnancy, such as contributing to gestational diabetes. |
|
| E28.2 | Polycystic ovarian syndrome | Use as a secondary code to indicate the presence of PCOS. |
|
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 pregnancy complicated by PCOS
Essential facts and insights about Pregnancy Complicated by Polycystic Ovary Syndrome
Primary ICD-10-CM Codes for pregnanc complicated by polycystic ovary
Decision Criteria
clinical Criteria
- PCOS must be documented as complicating the pregnancy.
coding Criteria
- O99.891 should be sequenced before E28.2.
Applicable To
- PCOS complicating pregnancy
Excludes
- Conditions not affecting pregnancy
Clinical Validation Requirements
- Documentation of PCOS impacting pregnancy
- Evidence of complications such as gestational diabetes or hypertension
Code-Specific Risks
- Incorrect sequencing without trimester specification
Coding Notes
- Ensure documentation links PCOS to pregnancy complications.
E28.2 - Polycystic ovarian syndrome
Use as a secondary code to indicate the presence of PCOS.
Applicable To
- PCOS
Excludes
- Other ovarian dysfunctions
Clinical Validation Requirements
- Laboratory confirmation of elevated androgens
- Ultrasound evidence of polycystic ovaries
Coding Notes
Always pair with O99.891 when PCOS complicates pregnancy.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Polycystic ovarian syndrome
E28.2Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Gestational diabetes mellitus
O24.4Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Pregnancy Complicated by Polycystic Ovary Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O99.891.
Impact
Clinical: Incomplete clinical picture, Regulatory: Non-compliance with documentation standards, Financial: Potential claim denials
Mitigation Strategy
Use templates to ensure comprehensive documentation, Educate providers on linking conditions
Impact
Reimbursement: May result in denial of claims due to incorrect coding., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate data on pregnancy complications.
Mitigation Strategy
Always use O99.891 as the primary code when PCOS complicates pregnancy.
Impact
Missing trimester details can lead to coding errors.
Mitigation Strategy
Ensure all documentation includes trimester and gestational age.
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 Pregnancy Complicated by Polycystic Ovary Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pregnancy Complicated by Polycystic Ovary Syndrome
Use these documentation templates to ensure complete and accurate documentation for Pregnancy Complicated by Polycystic Ovary Syndrome. These templates include all required elements for proper coding and billing.
PCOS complicating pregnancy with gestational diabetes
Specialty: ObstetricsRequired Elements
- Patient demographics
- Gestational age
- PCOS diagnosis
- Complications related to PCOS
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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