ICD-10 Coding for Pregnancy Complications(O24.412, O13.2)
Complete ICD-10-CM coding and documentation guide for Pregnancy Complications. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pregnancy Complications
O00-O9APrimary Range
Pregnancy, childbirth and the puerperium
This range covers all complications related to pregnancy, childbirth, and the puerperium, including specific conditions like gestational diabetes and pre-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 |
|---|---|---|---|
| O24.412 | Pre-existing type 2 diabetes mellitus in pregnancy, second trimester | Use when a patient with pre-existing type 2 diabetes is in the second trimester of pregnancy. |
|
| O13.2 | Gestational hypertension without significant proteinuria, second trimester | Use when a patient develops hypertension during the second trimester 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 codes for pregnancy complications
Essential facts and insights about Pregnancy Complications
Primary ICD-10-CM Codes for pregnancy complications
Decision Criteria
clinical Criteria
- Patient has a documented history of type 2 diabetes before pregnancy.
documentation Criteria
- Trimester of pregnancy is clearly documented.
Applicable To
- Type 2 diabetes mellitus complicating pregnancy
Excludes
- Gestational diabetes (O24.4-)
Clinical Validation Requirements
- Documented diagnosis of type 2 diabetes prior to pregnancy
- Blood glucose monitoring records
Code-Specific Risks
- Failure to document trimester can lead to incorrect coding.
Coding Notes
- Ensure documentation specifies pre-existing condition and trimester.
O13.2 - Gestational hypertension without significant proteinuria, second trimester
Use when a patient develops hypertension during the second trimester without significant proteinuria.
Applicable To
- Pregnancy-induced hypertension
Excludes
- Pre-existing hypertension (O10.-)
Clinical Validation Requirements
- Blood pressure readings ≥140/90 mmHg on two occasions
- No significant proteinuria
Coding Notes
Ensure documentation differentiates between gestational and pre-existing hypertension.
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 Pregnancy Complications to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O24.412.
Impact
Clinical: Inaccurate clinical assessment and management, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Use standardized templates that include gestational age fields, Regular training on documentation requirements
Impact
Reimbursement: May result in denied claims or reduced reimbursement., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Use appropriate complication codes from O00-O9A range.
Impact
Inaccurate or missing gestational age can lead to audit flags.
Mitigation Strategy
Implement mandatory fields in EHR for 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 Complications, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pregnancy Complications
Use these documentation templates to ensure complete and accurate documentation for Pregnancy Complications. These templates include all required elements for proper coding and billing.
Gestational Diabetes Management
Specialty: ObstetricsRequired Elements
- Patient demographics
- Gestational age
- Diabetes type and control status
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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