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ICD-10 Guide
ICD-10 CodesO21.8

O21.8

Billable

Other vomiting complicating pregnancy

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

Code Description

ICD-10 O21.8 is a billable code used to indicate a diagnosis of other vomiting complicating pregnancy.

Key Diagnostic Point:

O21.8 refers to other forms of vomiting that complicate pregnancy, which may include conditions such as hyperemesis gravidarum, severe nausea, and vomiting that can lead to dehydration and nutritional deficiencies. Hyperemesis gravidarum is characterized by persistent vomiting that can result in weight loss, electrolyte imbalances, and the need for hospitalization. Patients may require intravenous fluids and nutritional support to manage dehydration and maintain adequate nutrition. This condition can significantly impact the quality of life and may necessitate close monitoring and intervention by healthcare providers. Proper documentation of the severity of symptoms, treatment provided, and any associated complications is crucial for accurate coding and reimbursement.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between normal pregnancy-related nausea and hyperemesis gravidarum.
  • Documenting severity and frequency of vomiting episodes.
  • Identifying associated complications such as dehydration and electrolyte imbalances.
  • Understanding the need for nutritional support and intravenous therapy.

Audit Risk Factors

  • Inadequate documentation of symptoms and treatment.
  • Failure to specify the severity of vomiting.
  • Misclassification of hyperemesis gravidarum as normal nausea.
  • Lack of evidence for nutritional support provided.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of symptoms, treatment plans, and patient responses is essential. Include any consultations with dietitians or specialists.

Common Clinical Scenarios

Patients presenting with severe nausea and vomiting requiring hospitalization, or outpatient management with dietary modifications.

Billing Considerations

Ensure clarity in documentation regarding the impact on daily activities and the need for interventions.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of maternal and fetal health, including any complications arising from severe vomiting.

Common Clinical Scenarios

Management of high-risk pregnancies where hyperemesis gravidarum is present, requiring multidisciplinary care.

Billing Considerations

Focus on the implications for fetal growth and development, and the need for close monitoring.

Coding Guidelines

Inclusion Criteria

Use O21.8 When
  • Follow official ICD
  • CM guidelines for coding pregnancy
  • related conditions, ensuring that the documentation supports the diagnosis and reflects the severity of the condition

Exclusion Criteria

Do NOT use O21.8 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 hyperemesis gravidarum is admitted for severe dehydration.

Documentation Requirements

Document the patient's history, examination findings, and treatment plan.

Specialty Considerations

Ensure that the medical necessity for hospitalization is clearly documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of pregnancy-related conditions, improving the ability to capture the severity and complexity of cases like hyperemesis gravidarum.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of pregnancy-related conditions, improving the ability to capture the severity and complexity of cases like hyperemesis gravidarum.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of pregnancy-related conditions, improving the ability to capture the severity and complexity of cases like hyperemesis gravidarum.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG) Guidelines

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG) Guidelines

Frequently Asked Questions

What distinguishes hyperemesis gravidarum from normal pregnancy nausea?

Hyperemesis gravidarum is characterized by severe, persistent vomiting that leads to dehydration and weight loss, requiring medical intervention, whereas normal pregnancy nausea is typically mild and self-limiting.