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ICD-10 Guide
ICD-10 CodesO12.24

O12.24

Billable

Gestational edema with proteinuria, complicating childbirth

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

Code Description

ICD-10 O12.24 is a billable code used to indicate a diagnosis of gestational edema with proteinuria, complicating childbirth.

Key Diagnostic Point:

Gestational edema with proteinuria is a condition that occurs during pregnancy characterized by the accumulation of excess fluid in the body's tissues, leading to swelling, particularly in the lower extremities. This condition is often accompanied by proteinuria, which is the presence of excess protein in the urine, indicating potential kidney involvement. In the absence of hypertension, this condition can complicate childbirth by increasing the risk of adverse outcomes for both the mother and the fetus. It is essential for healthcare providers to monitor the patient's symptoms closely, as the presence of proteinuria may signal underlying issues that require intervention. Management typically involves careful monitoring, lifestyle modifications, and in some cases, medication to alleviate symptoms and ensure the safety of both mother and child during delivery. Accurate coding of this condition is crucial for appropriate treatment and reimbursement, as it reflects the complexity of the patient's clinical status during childbirth.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between gestational edema and other forms of edema.
  • Identifying the presence of proteinuria without hypertension.
  • Understanding the implications of gestational edema on labor and delivery.
  • Documenting the clinical significance of proteinuria in the absence of hypertension.

Audit Risk Factors

  • Inadequate documentation of proteinuria levels.
  • Failure to specify the absence of hypertension.
  • Misclassification of edema type.
  • Lack of clear clinical rationale for the diagnosis.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of edema symptoms, protein levels, and absence of hypertension is essential for accurate coding.

Common Clinical Scenarios

Patients presenting with swelling in the legs and proteinuria during routine prenatal visits.

Billing Considerations

Consideration of the patient's overall health and any comorbid conditions that may affect coding.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including gestational diabetes or pre-existing conditions.

Common Clinical Scenarios

Management of patients with multiple risk factors for preeclampsia.

Billing Considerations

In-depth assessment of fetal well-being and maternal health is critical.

Coding Guidelines

Inclusion Criteria

Use O12.24 When
  • According to the official ICD
  • 10 coding guidelines, O12
  • 24 should be used when gestational edema with proteinuria is documented without the presence of hypertension
  • Coders must ensure that the clinical documentation supports the diagnosis and that all relevant details are captured

Exclusion Criteria

Do NOT use O12.24 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59400CPT Code

Routine obstetric care including antepartum care

Clinical Scenario

Used for comprehensive prenatal care visits where gestational edema and proteinuria are monitored.

Documentation Requirements

Documentation of all prenatal visits, including assessments of edema and protein levels.

Specialty Considerations

Obstetricians should ensure that all relevant clinical findings are documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including gestational edema with proteinuria. This specificity helps in better tracking of maternal health outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including gestational edema with proteinuria. This specificity helps in better tracking of maternal health outcomes and resource allocation.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of coding O12.24?

Coding O12.24 accurately reflects the patient's condition of gestational edema with proteinuria, which is crucial for appropriate management and reimbursement. It indicates the need for careful monitoring during pregnancy and delivery.