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ICD-10 Guide
ICD-10 CodesO13.1

O13.1

Billable

Gestational [pregnancy-induced] hypertension without significant proteinuria, first trimester

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

Code Description

ICD-10 O13.1 is a billable code used to indicate a diagnosis of gestational [pregnancy-induced] hypertension without significant proteinuria, first trimester.

Key Diagnostic Point:

Gestational hypertension, also known as pregnancy-induced hypertension, is characterized by elevated blood pressure that develops after 20 weeks of gestation in a previously normotensive woman. In the case of O13.1, this condition occurs during the first trimester and is defined by a systolic blood pressure of 140 mmHg or higher, or a diastolic blood pressure of 90 mmHg or higher, without significant proteinuria. It is crucial to monitor blood pressure closely during this period, as early detection and management can prevent progression to more severe forms of hypertension, such as preeclampsia. Regular prenatal visits should include blood pressure checks, and any abnormal readings should prompt further evaluation and potential intervention. The absence of significant proteinuria distinguishes this condition from preeclampsia, allowing for a more focused treatment approach aimed at managing hypertension while minimizing risks to both the mother and fetus.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between gestational hypertension and chronic hypertension.
  • Understanding the significance of proteinuria in obstetric coding.
  • Monitoring and documenting blood pressure readings accurately.
  • Recognizing the potential for progression to more severe hypertensive disorders.

Audit Risk Factors

  • Inaccurate blood pressure documentation.
  • Failure to note the absence of proteinuria.
  • Misclassification of gestational hypertension as preeclampsia.
  • Inconsistent trimester documentation.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include detailed blood pressure readings, gestational age, and any symptoms or complications.

Common Clinical Scenarios

Routine prenatal visits where blood pressure is monitored, and management plans are discussed.

Billing Considerations

Ensure that all relevant clinical findings are documented to support the diagnosis of gestational hypertension.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of maternal and fetal assessments, including ultrasound findings and any interventions.

Common Clinical Scenarios

High-risk pregnancies where close monitoring of maternal blood pressure is essential.

Billing Considerations

Consideration of additional risk factors such as obesity, age, and previous hypertensive disorders.

Coding Guidelines

Inclusion Criteria

Use O13.1 When
  • Follow the official ICD
  • CM guidelines for coding hypertension in pregnancy, ensuring that the diagnosis is supported by clinical documentation and that the correct trimester is noted

Exclusion Criteria

Do NOT use O13.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, level 3

Clinical Scenario

Used during routine prenatal visits for monitoring blood pressure and overall health.

Documentation Requirements

Document blood pressure readings, gestational age, and any symptoms.

Specialty Considerations

Ensure that the visit is clearly linked to the management of gestational hypertension.

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 diagnoses and facilitating better management of pregnancy-related conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of gestational hypertension, improving the accuracy of diagnoses and facilitating better management of pregnancy-related conditions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of gestational hypertension, improving the accuracy of diagnoses and facilitating better management of pregnancy-related conditions.

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 elevated blood pressure without significant proteinuria, while preeclampsia involves both elevated blood pressure and significant proteinuria, along with potential systemic complications.