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ICD-10 Guide
ICD-10 CodesO23.5

O23.5

Billable

Infections of the genital tract in pregnancy

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

Code Description

ICD-10 O23.5 is a billable code used to indicate a diagnosis of infections of the genital tract in pregnancy.

Key Diagnostic Point:

Infections of the genital tract during pregnancy can significantly impact maternal and fetal health. These infections may include bacterial vaginosis, vulvovaginal candidiasis, and sexually transmitted infections (STIs) such as chlamydia and gonorrhea. The presence of these infections can lead to complications such as preterm labor, low birth weight, and postpartum infections. It is crucial for healthcare providers to accurately diagnose and treat these infections to mitigate risks. Treatment often involves the use of antibiotics, which must be selected carefully to ensure safety for both the mother and the fetus. Certain antibiotics, such as penicillins and cephalosporins, are generally considered safe during pregnancy, while others may pose risks. Regular screening and appropriate management of genital tract infections are essential components of prenatal care to promote healthy pregnancy outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of infections that can be coded under this category
  • Need for accurate documentation of infection type and treatment
  • Potential for overlapping symptoms with other conditions
  • Variability in antibiotic safety profiles during pregnancy

Audit Risk Factors

  • Inadequate documentation of infection type and treatment
  • Failure to specify if the infection is acute or chronic
  • Misclassification of infections as non-obstetric
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of symptoms, diagnostic tests, and treatment plans is essential. Providers should note any relevant history of STIs or previous infections.

Common Clinical Scenarios

A pregnant patient presenting with symptoms of a urinary tract infection (UTI) or vaginitis, requiring diagnostic testing and treatment.

Billing Considerations

Coders must be aware of the implications of untreated infections on pregnancy outcomes and ensure that all relevant details are captured.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancies require thorough documentation of maternal health, including any infections and their management.

Common Clinical Scenarios

Management of a pregnant patient with a history of recurrent UTIs or STIs, necessitating a multidisciplinary approach.

Billing Considerations

High-risk patients may require additional monitoring and follow-up, which should be documented to support coding.

Coding Guidelines

Inclusion Criteria

Use O23.5 When
  • Coders should follow the official ICD
  • 10 guidelines for obstetric coding, ensuring that the diagnosis is supported by clinical documentation
  • Specific criteria for infections during pregnancy must be met, including the timing of the infection relative to the pregnancy

Exclusion Criteria

Do NOT use O23.5 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

87491CPT Code

Chlamydia and gonorrhea testing

Clinical Scenario

Used during routine prenatal visits for screening STIs.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Obstetricians should ensure that testing aligns with current guidelines for STI screening in pregnancy.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of infections during pregnancy, improving the ability to track and manage these conditions effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of infections during pregnancy, improving the ability to track and manage these conditions effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of infections during pregnancy, improving the ability to track and manage these conditions effectively.

Resources

Clinical References

  • •
    CDC Guidelines for STI Screening in Pregnancy

Coding & Billing References

  • •
    CDC Guidelines for STI Screening in Pregnancy

Frequently Asked Questions

What are the common infections coded under O23.5?

Common infections include bacterial vaginosis, vulvovaginal candidiasis, and STIs such as chlamydia and gonorrhea. Accurate coding requires documentation of the specific infection type.