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ICD-10 Guide
ICD-10 CodesO21.2

O21.2

Billable

Late vomiting of pregnancy

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

Code Description

ICD-10 O21.2 is a billable code used to indicate a diagnosis of late vomiting of pregnancy.

Key Diagnostic Point:

Late vomiting of pregnancy, classified under ICD-10 code O21.2, refers to severe nausea and vomiting that occurs in the later stages of pregnancy, typically after the first trimester. This condition can significantly impact a woman's nutritional status and hydration levels, leading to complications such as hyperemesis gravidarum. Hyperemesis gravidarum is characterized by persistent vomiting, weight loss, electrolyte imbalances, and dehydration, necessitating medical intervention. Patients may require hospitalization for intravenous fluids and nutritional support, including parenteral nutrition if oral intake is insufficient. The management of late vomiting of pregnancy focuses on symptom relief, hydration, and ensuring adequate nutrition to support both maternal and fetal health. It is crucial for healthcare providers to monitor the severity of symptoms and adjust treatment plans accordingly, as untreated hyperemesis can lead to serious maternal and fetal complications.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between normal pregnancy nausea and hyperemesis gravidarum.
  • Assessing the severity of dehydration and nutritional deficiencies.
  • Documenting the need for hospitalization and intravenous therapy.
  • Understanding the implications of co-existing conditions.

Audit Risk Factors

  • Inadequate documentation of symptom severity and duration.
  • Failure to document the need for hospitalization or IV therapy.
  • Misclassification of normal pregnancy nausea as hyperemesis.
  • Lack of follow-up documentation on treatment outcomes.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of symptoms, treatment plans, and patient responses is essential for accurate coding.

Common Clinical Scenarios

Patients presenting with severe nausea and vomiting requiring hospitalization for IV fluids and nutritional support.

Billing Considerations

Consideration of the patient's overall health, weight changes, and any co-existing medical conditions that may complicate treatment.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of maternal and fetal health, including any high-risk factors.

Common Clinical Scenarios

Management of high-risk pregnancies with severe hyperemesis gravidarum requiring specialized care.

Billing Considerations

Close monitoring of fetal well-being and maternal nutritional status is critical.

Coding Guidelines

Inclusion Criteria

Use O21.2 When
  • According to official coding guidelines, O21
  • 2 should be used when the vomiting is severe enough to require medical intervention, such as hospitalization or IV therapy
  • Documentation must clearly indicate the severity and impact on the patient's health

Exclusion Criteria

Do NOT use O21.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99223CPT Code

Initial hospital care, typically 70 minutes or more

Clinical Scenario

Used when a patient with late vomiting of pregnancy is admitted for severe dehydration and requires comprehensive evaluation.

Documentation Requirements

Detailed documentation of the patient's history, examination findings, and treatment plan.

Specialty Considerations

Obstetricians should ensure that all relevant symptoms and treatments are documented to support the level of care provided.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like late vomiting of pregnancy, enabling better tracking of complications and treatment outcomes. This specificity aids in research and quality improvement initiatives in obstetric care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like late vomiting of pregnancy, enabling better tracking of complications and treatment outcomes. This specificity aids in research and quality improvement initiatives in obstetric care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like late vomiting of pregnancy, enabling better tracking of complications and treatment outcomes. This specificity aids in research and quality improvement initiatives in obstetric care.

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 O21.2 and O21.1?

O21.2 is used for late vomiting of pregnancy that is severe and may require hospitalization, while O21.1 is for mild to moderate cases that do not necessitate such interventions.