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ICD-10 Guide
ICD-10 CodesO24.111

O24.111

Billable

Pre-existing type 2 diabetes mellitus, in pregnancy, first trimester

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

Code Description

ICD-10 O24.111 is a billable code used to indicate a diagnosis of pre-existing type 2 diabetes mellitus, in pregnancy, first trimester.

Key Diagnostic Point:

Pre-existing type 2 diabetes mellitus in pregnancy poses significant risks to both the mother and fetus, particularly during the first trimester. This period is critical for fetal organ development, and uncontrolled diabetes can lead to congenital anomalies, miscarriage, and complications such as preeclampsia. Management of type 2 diabetes during pregnancy requires careful monitoring of blood glucose levels, dietary modifications, and potentially insulin therapy. Regular fetal monitoring is essential to assess fetal growth and well-being, as well as to detect any complications early. Healthcare providers must collaborate closely to ensure optimal maternal and fetal outcomes, adjusting treatment plans as necessary throughout the pregnancy.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Need for accurate documentation of pre-existing conditions
  • Variability in treatment protocols based on individual patient needs
  • Potential for multiple comorbidities affecting coding
  • Frequent updates in clinical guidelines for diabetes management in pregnancy

Audit Risk Factors

  • Inadequate documentation of diabetes management
  • Failure to document fetal monitoring results
  • Incorrect coding of complications related to diabetes
  • Lack of clarity on the trimester of pregnancy

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of maternal health, glucose levels, and treatment plans.

Common Clinical Scenarios

Routine prenatal visits, management of diabetes during pregnancy, and monitoring for complications.

Billing Considerations

Ensure documentation reflects the impact of diabetes on pregnancy outcomes and any changes in management.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive assessments of maternal-fetal health, including ultrasound findings and lab results.

Common Clinical Scenarios

High-risk consultations, management of complications, and specialized fetal monitoring.

Billing Considerations

Focus on the interplay between maternal diabetes and fetal development, requiring detailed documentation of both.

Coding Guidelines

Inclusion Criteria

Use O24.111 When
  • Follow the official ICD
  • CM guidelines for coding diabetes in pregnancy, ensuring that the code reflects the patient's condition accurately and includes any relevant complications

Exclusion Criteria

Do NOT use O24.111 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, level 3

Clinical Scenario

Used for routine follow-up visits for diabetes management during pregnancy.

Documentation Requirements

Document patient's diabetes management plan, glucose levels, and any changes in treatment.

Specialty Considerations

Obstetricians should ensure that diabetes management is integrated into overall prenatal care.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

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

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    American Diabetes Association: Standards of Medical Care in Diabetes

Coding & Billing References

  • •
    American Diabetes Association: Standards of Medical Care in Diabetes

Frequently Asked Questions

What is the significance of coding O24.111 accurately?

Accurate coding of O24.111 is crucial for ensuring appropriate management of pre-existing diabetes during pregnancy, which can significantly impact maternal and fetal health outcomes. It also affects reimbursement and quality metrics for healthcare providers.