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ICD-10 Guide
ICD-10 CodesO24.3

O24.3

Billable

Unspecified pre-existing diabetes mellitus in pregnancy, childbirth and the puerperium

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

Code Description

ICD-10 O24.3 is a billable code used to indicate a diagnosis of unspecified pre-existing diabetes mellitus in pregnancy, childbirth and the puerperium.

Key Diagnostic Point:

Unspecified pre-existing diabetes mellitus in pregnancy, childbirth, and the puerperium refers to a condition where a woman has diabetes that existed prior to her pregnancy but is not specifically classified as type 1 or type 2 diabetes. This condition can lead to various complications during pregnancy, including increased risk of fetal macrosomia, preeclampsia, and cesarean delivery. Management typically involves careful monitoring of blood glucose levels, dietary modifications, and potentially insulin therapy to maintain optimal glycemic control. Fetal monitoring is crucial to assess fetal well-being and growth, as well as to detect any potential complications early. The healthcare team must collaborate closely to ensure both maternal and fetal health throughout the pregnancy and postpartum period.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between type 1 and type 2 diabetes when unspecified.
  • Managing insulin therapy and adjustments during pregnancy.
  • Monitoring for potential complications such as gestational hypertension.
  • Documenting the impact of diabetes on fetal health and development.

Audit Risk Factors

  • Inadequate documentation of pre-existing diabetes status.
  • Failure to document insulin management and adjustments.
  • Lack of detailed fetal monitoring records.
  • Inconsistent coding of complications related to diabetes.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include the type of diabetes, management strategies, and any complications encountered during pregnancy.

Common Clinical Scenarios

Patients with a history of diabetes presenting for prenatal care, requiring insulin management adjustments, and monitoring for fetal growth abnormalities.

Billing Considerations

Accurate coding requires clear documentation of the patient's diabetes history and any changes in management during pregnancy.

Maternal-Fetal Medicine

Documentation Requirements

Detailed records of high-risk assessments, fetal monitoring results, and multidisciplinary care plans.

Common Clinical Scenarios

High-risk pregnancies involving pre-existing diabetes with potential complications such as fetal growth restriction or macrosomia.

Billing Considerations

Special attention to the management of diabetes and its impact on both maternal and fetal health is crucial.

Coding Guidelines

Inclusion Criteria

Use O24.3 When
  • According to ICD
  • 10 guidelines, O24
  • 3 should be used when a patient has a documented history of diabetes prior to pregnancy without specification of type
  • It is essential to document the management plan and any complications to support the use of this code

Exclusion Criteria

Do NOT use O24.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99203CPT Code

Office or other outpatient visit for the evaluation and management of a new patient, which may include diabetes management.

Clinical Scenario

Used during routine prenatal visits for patients with pre-existing diabetes.

Documentation Requirements

Documentation must include a review of diabetes management and any changes in treatment.

Specialty Considerations

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

59400CPT Code

Global obstetric care, including antepartum, delivery, and postpartum care.

Clinical Scenario

Used for comprehensive care of a patient with pre-existing diabetes throughout pregnancy.

Documentation Requirements

Complete documentation of diabetes management and any complications during the global period.

Specialty Considerations

Obstetricians must coordinate care with endocrinologists when managing diabetes.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of diabetes-related conditions, improving the accuracy of diagnoses and management strategies in obstetric care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of diabetes-related conditions, improving the accuracy of diagnoses and management strategies in obstetric care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of diabetes-related conditions, improving the accuracy of diagnoses and management strategies in obstetric care.

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 difference between pre-existing diabetes and gestational diabetes?

Pre-existing diabetes refers to diabetes that was diagnosed before pregnancy, while gestational diabetes develops during pregnancy. Accurate coding requires distinguishing between the two, as management and implications for the pregnancy differ significantly.