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ICD-10 Guide
ICD-10 CodesO21.9

O21.9

Billable

Vomiting of pregnancy, unspecified

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

Code Description

ICD-10 O21.9 is a billable code used to indicate a diagnosis of vomiting of pregnancy, unspecified.

Key Diagnostic Point:

Vomiting of pregnancy, classified under ICD-10 code O21.9, refers to a condition characterized by nausea and vomiting occurring during pregnancy. This condition can range from mild nausea to severe vomiting, which may lead to hyperemesis gravidarum, a more serious form of pregnancy-related vomiting. Hyperemesis gravidarum is marked by persistent vomiting that can result in dehydration, electrolyte imbalances, and nutritional deficiencies. Patients may require hospitalization for intravenous fluids and nutritional support if they cannot maintain adequate oral intake. The condition typically arises in the first trimester but can persist throughout pregnancy. Management strategies include dietary modifications, antiemetic medications, and in severe cases, hospitalization for supportive care. Accurate coding is essential for appropriate treatment and reimbursement, as well as for tracking maternal health outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between normal pregnancy-related nausea and hyperemesis gravidarum.
  • Determining the severity of symptoms and their impact on hydration and nutrition.
  • Documenting the need for hospitalization and intravenous therapy.
  • Understanding the implications of co-existing conditions such as pre-existing gastrointestinal disorders.

Audit Risk Factors

  • Inadequate documentation of symptom severity and duration.
  • Failure to document the need for hospitalization or IV therapy.
  • Misclassification of normal vomiting versus hyperemesis gravidarum.
  • Lack of follow-up documentation on patient outcomes.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with severe nausea and vomiting, requiring dietary changes or medication.

Billing Considerations

Consideration of the patient's overall health and any pre-existing conditions that may complicate treatment.

Maternal-Fetal Medicine

Documentation Requirements

Thorough documentation of high-risk factors and management strategies for severe cases.

Common Clinical Scenarios

Management of patients with hyperemesis gravidarum requiring specialized care.

Billing Considerations

Focus on maternal and fetal health outcomes, including nutritional status and hydration.

Coding Guidelines

Inclusion Criteria

Use O21.9 When
  • According to official coding guidelines, O21
  • 9 should be used when the specific cause of vomiting in pregnancy is not documented
  • Coders should ensure that the diagnosis aligns with the clinical documentation and that any associated conditions are also coded appropriately

Exclusion Criteria

Do NOT use O21.9 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 for patients experiencing vomiting during pregnancy.

Documentation Requirements

Documentation of symptoms, treatment plan, and patient response.

Specialty Considerations

Obstetricians should ensure that all relevant details are captured to support the visit level.

96372CPT Code

Therapeutic, prophylactic, or diagnostic injection

Clinical Scenario

Administering antiemetic medication for severe nausea.

Documentation Requirements

Record the medication administered and the patient's response.

Specialty Considerations

Ensure that the indication for the injection 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 track and manage complications such as vomiting of pregnancy. This specificity aids in better patient care and more accurate reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of pregnancy-related conditions, improving the ability to track and manage complications such as vomiting of pregnancy. This specificity aids in better patient care and more accurate reimbursement.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)
  • •
    Centers for Disease Control and Prevention (CDC) - Pregnancy

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)
  • •
    Centers for Disease Control and Prevention (CDC) - Pregnancy

Frequently Asked Questions

What is the difference between O21.9 and O21.0?

O21.9 is used for unspecified vomiting of pregnancy, while O21.0 specifically refers to hyperemesis gravidarum, which is a more severe condition requiring specific management.

When should I use O21.9?

Use O21.9 when the documentation does not specify the severity of vomiting or when the patient does not meet the criteria for hyperemesis gravidarum.