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ICD-10 Guide
ICD-10 CodesO14.04

O14.04

Billable

Mild to moderate pre-eclampsia, complicating childbirth

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

Code Description

ICD-10 O14.04 is a billable code used to indicate a diagnosis of mild to moderate pre-eclampsia, complicating childbirth.

Key Diagnostic Point:

Mild to moderate pre-eclampsia is a hypertensive disorder that occurs after 20 weeks of gestation and is characterized by elevated blood pressure and proteinuria. This condition can complicate childbirth, posing risks to both the mother and fetus. In mild to moderate cases, blood pressure readings are typically between 140/90 mmHg and 160/110 mmHg, with protein levels in urine being less than 5 grams in 24 hours. Management often includes close monitoring of maternal and fetal health, lifestyle modifications, and possibly medication to control blood pressure. The condition can progress to severe pre-eclampsia or eclampsia if not properly managed. The use of magnesium sulfate is a common protocol to prevent seizures in women with severe features of pre-eclampsia. It is crucial for healthcare providers to document the severity of the condition, treatment protocols, and any complications that arise during childbirth to ensure accurate coding and optimal patient care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between mild, moderate, and severe pre-eclampsia.
  • Understanding the implications of HELLP syndrome.
  • Documenting the use of magnesium sulfate and its indications.
  • Monitoring and coding for potential complications during childbirth.

Audit Risk Factors

  • Inadequate documentation of blood pressure readings.
  • Failure to document the presence of proteinuria.
  • Lack of clarity on the treatment administered (e.g., magnesium sulfate).
  • Not specifying the timing of onset in relation to childbirth.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of blood pressure readings, proteinuria tests, and treatment plans.

Common Clinical Scenarios

Management of mild to moderate pre-eclampsia during labor and delivery.

Billing Considerations

Ensure accurate coding based on the severity of pre-eclampsia and any interventions performed.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including maternal history and fetal assessments.

Common Clinical Scenarios

Monitoring and managing high-risk pregnancies with pre-eclampsia.

Billing Considerations

Focus on the potential for progression to severe pre-eclampsia or HELLP syndrome.

Coding Guidelines

Inclusion Criteria

Use O14.04 When
  • Follow the official ICD
  • CM guidelines for coding obstetric conditions, ensuring that the diagnosis is supported by clinical documentation
  • Specific criteria for pre
  • eclampsia include blood pressure thresholds and proteinuria levels, which must be clearly documented in the patient's medical record

Exclusion Criteria

Do NOT use O14.04 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59400CPT Code

Obstetrical delivery, vaginal

Clinical Scenario

Used when delivering a patient with mild to moderate pre-eclampsia.

Documentation Requirements

Document the patient's condition, treatment administered, and any complications.

Specialty Considerations

Obstetricians should ensure that all aspects of care are documented to support coding.

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 pre-eclampsia. This specificity aids in better tracking of maternal and fetal outcomes and enhances the ability to analyze healthcare data related to pregnancy complications.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including pre-eclampsia. This specificity aids in better tracking of maternal and fetal outcomes and enhances the ability to analyze healthcare data related to pregnancy complications.

Reimbursement & Billing Impact

reimbursement and quality reporting.

Resources

Clinical References

  • •
    ACOG Practice Bulletin on Hypertension in Pregnancy

Coding & Billing References

  • •
    ACOG Practice Bulletin on Hypertension in Pregnancy

Frequently Asked Questions

What is the difference between mild and moderate pre-eclampsia?

Mild pre-eclampsia is characterized by blood pressure readings of 140/90 mmHg to 159/109 mmHg and proteinuria less than 5 grams in 24 hours. Moderate pre-eclampsia may present with slightly higher blood pressure readings and requires careful monitoring to prevent progression.