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v1.0.0
ICD-10 Guide
ICD-10 CodesO23.4

O23.4

Billable

Unspecified infection of urinary tract in pregnancy

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

Code Description

ICD-10 O23.4 is a billable code used to indicate a diagnosis of unspecified infection of urinary tract in pregnancy.

Key Diagnostic Point:

Unspecified urinary tract infections (UTIs) during pregnancy can pose significant risks to both the mother and fetus. These infections may arise from various pathogens and can lead to complications such as pyelonephritis, preterm labor, and low birth weight. Symptoms often include dysuria, frequency, urgency, and suprapubic pain. Diagnosis typically involves urinalysis and urine culture to identify the causative organism. Treatment is crucial and usually involves antibiotics that are safe for use during pregnancy. Commonly prescribed antibiotics include penicillins and cephalosporins, which have a favorable safety profile. However, it is essential to avoid certain medications, such as tetracyclines and fluoroquinolones, due to potential adverse effects on fetal development. Regular screening for UTIs is recommended in pregnant women, especially those with risk factors such as a history of recurrent UTIs or anatomical abnormalities.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation of UTIs in pregnancy
  • Need for accurate documentation of symptoms and treatment
  • Differentiation from other urinary conditions
  • Consideration of antibiotic safety and efficacy

Audit Risk Factors

  • Inadequate documentation of symptoms and treatment
  • Failure to specify the type of urinary tract infection
  • Misuse of unspecified codes leading to denials
  • Inconsistent coding practices across providers

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of symptoms, diagnostic tests, and treatment plans is essential for accurate coding.

Common Clinical Scenarios

A pregnant patient presents with dysuria and is diagnosed with a UTI after urinalysis.

Billing Considerations

Coders must ensure that the infection is documented as occurring during pregnancy and note any complications.

Maternal-Fetal Medicine

Documentation Requirements

Documentation must include maternal health history, risk factors, and any fetal monitoring results.

Common Clinical Scenarios

A high-risk pregnant patient with a history of recurrent UTIs is monitored closely for complications.

Billing Considerations

High-risk factors must be clearly documented to support the complexity of care provided.

Coding Guidelines

Inclusion Criteria

Use O23.4 When
  • Follow the official ICD
  • CM guidelines for coding obstetric conditions, ensuring that the pregnancy status is clearly documented and that the infection is appropriately classified

Exclusion Criteria

Do NOT use O23.4 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

87086CPT Code

Urine culture, bacterial

Clinical Scenario

Used when a pregnant patient presents with UTI symptoms.

Documentation Requirements

Document the reason for the culture and any previous UTI history.

Specialty Considerations

Ensure that the culture results are linked to the diagnosis for accurate 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, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    CDC Guidelines for Antibiotic Use in Pregnancy

Coding & Billing References

  • •
    CDC Guidelines for Antibiotic Use in Pregnancy

Frequently Asked Questions

What are the common symptoms of a urinary tract infection in pregnancy?

Common symptoms include dysuria, increased frequency and urgency of urination, and suprapubic pain. Some women may also experience fever and flank pain if the infection progresses.