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ICD-10 Guide
ICD-10 CodesO24.312

O24.312

Billable

Unspecified pre-existing diabetes mellitus in pregnancy, second trimester

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

Code Description

ICD-10 O24.312 is a billable code used to indicate a diagnosis of unspecified pre-existing diabetes mellitus in pregnancy, second trimester.

Key Diagnostic Point:

Unspecified pre-existing diabetes mellitus in pregnancy during the second trimester refers to a condition where a woman with diabetes prior to pregnancy experiences complications or management challenges during the second trimester. This condition requires careful monitoring and management to prevent adverse outcomes for both the mother and fetus. Women with pre-existing diabetes may face increased risks of complications such as hypertensive disorders, fetal growth abnormalities, and preterm labor. Insulin management is often necessary to maintain optimal blood glucose levels, which is crucial for fetal development. Regular fetal monitoring through ultrasound and non-stress tests is essential to assess fetal well-being and growth patterns. The healthcare team must collaborate closely to adjust treatment plans as needed, ensuring both maternal and fetal health are prioritized throughout the pregnancy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in diabetes management protocols among providers
  • Need for precise documentation of pre-existing conditions
  • Potential for multiple comorbidities affecting pregnancy
  • Frequent changes in treatment plans based on glucose monitoring

Audit Risk Factors

  • Inadequate documentation of pre-existing diabetes
  • Failure to document insulin management adjustments
  • Lack of fetal monitoring records
  • Misclassification of diabetes type

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

Management of insulin therapy adjustments, monitoring for fetal growth abnormalities, and addressing maternal health issues.

Billing Considerations

Coders must ensure that all relevant clinical details are captured to support the diagnosis and treatment plan.

Maternal-Fetal Medicine

Documentation Requirements

Detailed records of high-risk assessments, ultrasound findings, and any interventions performed.

Common Clinical Scenarios

Monitoring for fetal anomalies, managing maternal complications, and coordinating care with endocrinology.

Billing Considerations

High-risk pregnancies require thorough documentation to justify the complexity of care and associated coding.

Coding Guidelines

Inclusion Criteria

Use O24.312 When
  • According to ICD
  • 10 guidelines, coders must ensure that the diabetes is documented as pre
  • existing and that the trimester of pregnancy is specified
  • Accurate coding requires understanding the implications of diabetes on pregnancy outcomes and the necessary management strategies

Exclusion Criteria

Do NOT use O24.312 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99203CPT Code

Office visit for established patient, moderate complexity

Clinical Scenario

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

Documentation Requirements

Documentation must include assessment of diabetes management and any changes made.

Specialty Considerations

Obstetricians must 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. This specificity helps in tracking outcomes and managing care effectively.

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. This specificity helps in tracking outcomes and managing care effectively.

Reimbursement & Billing Impact

reimbursement processes. This specificity helps in tracking outcomes and managing care effectively.

Resources

Clinical References

  • •
    American Diabetes Association - Diabetes and Pregnancy

Coding & Billing References

  • •
    American Diabetes Association - Diabetes and Pregnancy

Frequently Asked Questions

What is the difference between pre-existing diabetes and gestational diabetes?

Pre-existing diabetes refers to diabetes diagnosed before pregnancy, while gestational diabetes develops during pregnancy. Accurate coding is essential to reflect the patient's condition correctly.