ICD-10 Coding for Pyelonephritis in Pregnancy(O23.01, O23.02, O23.03)
Complete ICD-10-CM coding and documentation guide for Pyelonephritis in Pregnancy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pyelonephritis in Pregnancy
O23.0-O23.9Primary Range
Infections of genitourinary tract in pregnancy
This range includes codes for infections of the genitourinary tract during pregnancy, including pyelonephritis.
Renal tubulo-interstitial diseases
Includes codes for acute and chronic pyelonephritis not specified as complicating 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 |
|---|---|---|---|
| O23.01 | Infections of genitourinary tract in pregnancy, first trimester | Use when pyelonephritis is documented as complicating pregnancy in the first trimester. |
|
| O23.02 | Infections of genitourinary tract in pregnancy, second trimester | Use when pyelonephritis is documented as complicating pregnancy in the second trimester. |
|
| O23.03 | Infections of genitourinary tract in pregnancy, third trimester | Use when pyelonephritis is documented as complicating pregnancy in the third 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 pyelonephritis in pregnancy
Essential facts and insights about Pyelonephritis in Pregnancy
Primary ICD-10-CM Codes for pyelonephritis in pregnancy
Decision Criteria
clinical Criteria
- Presence of fever, flank pain, and positive urine culture
documentation Criteria
- Explicit statement that pyelonephritis is complicating pregnancy
Applicable To
- Acute pyelonephritis complicating pregnancy in the first trimester
Excludes
- Chronic pyelonephritis (N11.0)
Clinical Validation Requirements
- Fever ≥38°C
- Costovertebral angle tenderness
- Positive urine culture (≥10^5 CFU/mL)
Code-Specific Risks
- Incorrect trimester specification can lead to coding errors.
Coding Notes
- Ensure documentation specifies the infection as complicating the pregnancy.
O23.02 - Infections of genitourinary tract in pregnancy, second trimester
Use when pyelonephritis is documented as complicating pregnancy in the second trimester.
Applicable To
- Acute pyelonephritis complicating pregnancy in the second trimester
Excludes
- Chronic pyelonephritis (N11.0)
Clinical Validation Requirements
- Fever ≥38°C
- Costovertebral angle tenderness
- Positive urine culture (≥10^5 CFU/mL)
Coding Notes
Ensure documentation specifies the infection as complicating the pregnancy.
O23.03 - Infections of genitourinary tract in pregnancy, third trimester
Use when pyelonephritis is documented as complicating pregnancy in the third trimester.
Applicable To
- Acute pyelonephritis complicating pregnancy in the third trimester
Excludes
- Chronic pyelonephritis (N11.0)
Clinical Validation Requirements
- Fever ≥38°C
- Costovertebral angle tenderness
- Positive urine culture (≥10^5 CFU/mL)
Coding Notes
Ensure documentation specifies the infection as complicating the pregnancy.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Escherichia coli [E. coli] as the cause of diseases classified elsewhere
B96.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Pyelonephritis in Pregnancy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O23.01.
Impact
Clinical: Leads to misclassification of severity., Regulatory: May result in audit flags., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Educate providers on documentation specificity., Use templates that prompt for complication details.
Impact
Reimbursement: Incorrect coding can lead to lower DRG reimbursement., Compliance: May result in compliance issues during audits., Data Quality: Affects the accuracy of pregnancy-related health data.
Mitigation Strategy
Add O23.0- as primary if pregnancy complication is documented.
Impact
Reimbursement: Incorrect trimester coding can affect DRG assignment., Compliance: May lead to audit discrepancies., Data Quality: Impacts the quality of trimester-specific health data.
Mitigation Strategy
Query provider for exact trimester at diagnosis.
Impact
Using incorrect trimester codes can lead to audit discrepancies.
Mitigation Strategy
Verify trimester details in documentation before coding.
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 Pyelonephritis in Pregnancy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pyelonephritis in Pregnancy
Use these documentation templates to ensure complete and accurate documentation for Pyelonephritis in Pregnancy. These templates include all required elements for proper coding and billing.
Acute pyelonephritis in second trimester
Specialty: ObstetricsRequired Elements
- Patient history
- Symptoms
- Lab results
- Imaging findings
- Assessment
- Plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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