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ICD-10 Guide
ICD-10 CodesO13.3

O13.3

Billable

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

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

Code Description

ICD-10 O13.3 is a billable code used to indicate a diagnosis of gestational [pregnancy-induced] hypertension without significant proteinuria, third 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 O13.3, the condition occurs during the third trimester and is defined by systolic blood pressure readings of 140 mmHg or higher and/or diastolic readings of 90 mmHg or higher, without the presence of significant proteinuria. This condition can lead to complications such as preeclampsia if not monitored and managed appropriately. Regular blood pressure monitoring is crucial, as it helps in early detection and management of potential complications. Patients may present with symptoms such as headaches, visual disturbances, or epigastric pain, which necessitate further evaluation. Management typically involves lifestyle modifications, close monitoring, and in some cases, antihypertensive medications. The condition requires careful documentation of blood pressure readings, patient symptoms, and any interventions undertaken to ensure accurate coding and optimal patient care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between gestational hypertension and preeclampsia.
  • Monitoring and documenting blood pressure readings accurately.
  • Understanding the significance of proteinuria in relation to hypertension.
  • Managing potential complications and their documentation.

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, any symptoms experienced by the patient, and treatment plans.

Common Clinical Scenarios

Patients presenting with elevated blood pressure during routine prenatal visits, requiring monitoring and potential intervention.

Billing Considerations

Consideration of the patient's overall health, history of hypertension, and any medications that may affect blood pressure.

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 gestational hypertension is monitored closely due to potential complications.

Billing Considerations

Involvement of multidisciplinary teams for management of high-risk cases and ensuring all relevant data is captured.

Coding Guidelines

Inclusion Criteria

Use O13.3 When
  • According to ICD
  • CM guidelines, O13
  • 3 should be used when a patient presents with gestational hypertension without significant proteinuria during the third trimester
  • Accurate coding requires documentation of blood pressure readings and the absence of proteinuria

Exclusion Criteria

Do NOT use O13.3 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 blood pressure in patients diagnosed with gestational hypertension.

Documentation Requirements

Document blood pressure readings, patient symptoms, and any changes in management.

Specialty Considerations

Obstetricians should ensure that all relevant information is captured to support the diagnosis.

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 reimbursement processes. It emphasizes the importance of detailed documentation and differentiation between various hypertensive disorders in pregnancy.

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 reimbursement processes. It emphasizes the importance of detailed documentation and differentiation between various hypertensive disorders in pregnancy.

Reimbursement & Billing Impact

reimbursement processes. It emphasizes the importance of detailed documentation and differentiation between various hypertensive disorders in pregnancy.

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 includes both hypertension and significant proteinuria, along with potential end-organ dysfunction. Accurate diagnosis is crucial for appropriate management.