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ICD-10 Guide
ICD-10 CodesO24.434

O24.434

Billable

Gestational diabetes mellitus in the puerperium, insulin controlled

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/08/2025

Code Description

ICD-10 O24.434 is a billable code used to indicate a diagnosis of gestational diabetes mellitus in the puerperium, insulin controlled.

Key Diagnostic Point:

Gestational diabetes mellitus (GDM) is a condition characterized by glucose intolerance that is first recognized during pregnancy. When a woman with GDM requires insulin for glycemic control during the puerperium, it indicates that her condition is being actively managed post-delivery. The puerperium is the period following childbirth, typically lasting six weeks, during which the mother's body undergoes significant physiological changes as it returns to a non-pregnant state. Insulin management is crucial for these patients to prevent complications such as postpartum hemorrhage, infection, and the development of type 2 diabetes. Monitoring of blood glucose levels is essential, and healthcare providers must ensure that the patient receives appropriate dietary counseling and follow-up care. Fetal monitoring during pregnancy is also vital, as uncontrolled gestational diabetes can lead to macrosomia, neonatal hypoglycemia, and other adverse outcomes. Proper coding of this condition requires thorough documentation of the patient's insulin regimen, blood glucose levels, and any complications that may arise during the puerperium.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for accurate documentation of insulin management and blood glucose levels.
  • Differentiation between gestational diabetes and pre-existing diabetes.
  • Monitoring for potential complications in both mother and infant.
  • Understanding the timeline of the puerperium and its implications for care.

Audit Risk Factors

  • Inadequate documentation of insulin use and blood glucose monitoring.
  • Failure to document the patient's response to treatment.
  • Misclassification of gestational diabetes as type 1 or type 2 diabetes.
  • Lack of follow-up care documentation post-delivery.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of maternal health, insulin therapy, and glucose monitoring.

Common Clinical Scenarios

Management of GDM during pregnancy and transition to postpartum care.

Billing Considerations

Consideration of the mother's overall health and any comorbid conditions.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors and fetal monitoring results.

Common Clinical Scenarios

Management of high-risk pregnancies with GDM and potential fetal complications.

Billing Considerations

Focus on both maternal and fetal outcomes and the need for multidisciplinary care.

Coding Guidelines

Inclusion Criteria

Use O24.434 When
  • Follow the official ICD
  • CM guidelines for coding diabetes in pregnancy, ensuring that the specific type of diabetes and management strategies are clearly documented
  • The guidelines emphasize the importance of distinguishing between gestational diabetes and other types of diabetes

Exclusion Criteria

Do NOT use O24.434 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits to monitor GDM management post-delivery.

Documentation Requirements

Document patient's insulin regimen, blood glucose levels, and any complications.

Specialty Considerations

Ensure that the visit is clearly linked to the management of GDM.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of gestational diabetes, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of documenting the management of diabetes during and after pregnancy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of gestational diabetes, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of documenting the management of diabetes during and after pregnancy.

Reimbursement & Billing Impact

reimbursement processes. It emphasizes the importance of documenting the management of diabetes during and after pregnancy.

Resources

Clinical References

  • •
    American Diabetes Association: Gestational Diabetes

Coding & Billing References

  • •
    American Diabetes Association: Gestational Diabetes

Frequently Asked Questions

What is the significance of coding O24.434?

Coding O24.434 accurately reflects the management of gestational diabetes that requires insulin during the puerperium, ensuring appropriate care and follow-up for the mother and infant.