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ICD-10 Guide
ICD-10 CodesChapter 15: Pregnancy, childbirth and the puerperiumO13

O13

Billable

Gestational [pregnancy-induced] hypertension without significant proteinuria

Chapter 15:Pregnancy, childbirth and the puerperium

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

Code Description

ICD-10 O13 is a billable code used to indicate a diagnosis of gestational [pregnancy-induced] hypertension without significant proteinuria.

Key Diagnostic Point:

Gestational hypertension, also known as pregnancy-induced hypertension, is a condition characterized by elevated blood pressure that develops after 20 weeks of gestation in a previously normotensive woman. It is defined as a systolic blood pressure of 140 mmHg or higher, or a diastolic blood pressure of 90 mmHg or higher, without the presence of significant proteinuria (≥300 mg in a 24-hour urine collection). This condition can lead to complications for both the mother and fetus if not monitored and managed appropriately. Regular blood pressure monitoring is essential to detect any progression to more severe forms of hypertension, such as preeclampsia. Management typically includes lifestyle modifications, close monitoring, and, in some cases, antihypertensive medications. The absence of significant proteinuria differentiates this condition from preeclampsia, which is characterized by hypertension and protein in the urine. Understanding the nuances of gestational hypertension is crucial for ensuring appropriate care and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from preeclampsia and chronic hypertension
  • Need for accurate blood pressure documentation
  • Monitoring for progression of the condition
  • Variability in clinical presentation

Audit Risk Factors

  • Inadequate documentation of blood pressure readings
  • Failure to note the absence of proteinuria
  • Misclassification of gestational hypertension as preeclampsia
  • Lack of follow-up documentation on management and outcomes

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include detailed blood pressure readings, the absence of proteinuria, and any management strategies employed.

Common Clinical Scenarios

A patient presents with elevated blood pressure at a routine prenatal visit; monitoring and lifestyle modifications are discussed.

Billing Considerations

Coders should ensure that all relevant clinical notes are reviewed to capture the full context of the patient's condition.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancy documentation must include comprehensive assessments of maternal and fetal well-being, including blood pressure trends.

Common Clinical Scenarios

A high-risk patient with gestational hypertension is monitored closely for signs of progression to preeclampsia.

Billing Considerations

Special attention should be given to the management plan and any interventions that may affect coding.

Coding Guidelines

Inclusion Criteria

Use O13 When
  • Coders should refer to the official ICD
  • CM coding guidelines for obstetric conditions, ensuring that gestational hypertension is coded only when there is no significant proteinuria
  • Accurate blood pressure documentation is critical

Exclusion Criteria

Do NOT use O13 When
No specific exclusions found.

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for routine follow-up visits for patients with gestational hypertension.

Documentation Requirements

Documentation must include blood pressure readings and management plans.

Specialty Considerations

Obstetricians should ensure that all relevant clinical information is captured.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of gestational hypertension, improving the accuracy of data collection and management strategies for pregnant patients.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of gestational hypertension, improving the accuracy of data collection and management strategies for pregnant patients.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of gestational hypertension, improving the accuracy of data collection and management strategies for pregnant patients.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What is the difference between gestational hypertension and preeclampsia?

Gestational hypertension is characterized by high blood pressure without significant proteinuria, while preeclampsia involves both high blood pressure and protein in the urine, indicating a more severe condition that requires different management.