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ICD-10 Guide
ICD-10 CodesO24.313

O24.313

Billable

Unspecified pre-existing diabetes mellitus in pregnancy, third trimester

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

Code Description

ICD-10 O24.313 is a billable code used to indicate a diagnosis of unspecified pre-existing diabetes mellitus in pregnancy, third trimester.

Key Diagnostic Point:

Unspecified pre-existing diabetes mellitus in pregnancy during the third trimester refers to a condition where a woman has diabetes that existed prior to pregnancy and is now being managed during the later stages of gestation. This condition can lead to various complications for both the mother and fetus, including increased risk of macrosomia, preterm birth, and the need for cesarean delivery. Management typically involves careful monitoring of blood glucose levels, dietary modifications, and possibly insulin therapy to maintain glycemic control. Fetal monitoring is crucial to assess fetal well-being and growth, as well as to identify any potential complications early. The third trimester is particularly critical as the fetus undergoes significant growth and development, and maternal diabetes can impact these processes. Regular follow-ups with healthcare providers, including obstetricians and endocrinologists, are essential to ensure optimal outcomes for both mother and child.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in diabetes management protocols among providers
  • Need for detailed documentation of pre-existing conditions
  • Potential for multiple comorbidities affecting pregnancy
  • Variations in fetal monitoring practices

Audit Risk Factors

  • Inadequate documentation of pre-existing diabetes
  • Failure to document insulin management details
  • Lack of fetal monitoring records
  • Inconsistent coding of related complications

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

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

Common Clinical Scenarios

Management of a pregnant patient with pre-existing diabetes requiring insulin therapy and regular fetal monitoring.

Billing Considerations

Ensure accurate coding of any complications such as hypertensive disorders or fetal growth abnormalities.

Maternal-Fetal Medicine

Documentation Requirements

Detailed records of maternal-fetal assessments, including ultrasound findings and glucose monitoring logs.

Common Clinical Scenarios

High-risk pregnancies involving pre-existing diabetes with potential fetal complications.

Billing Considerations

Focus on the interdisciplinary approach to managing high-risk pregnancies and the importance of coordinated care.

Coding Guidelines

Inclusion Criteria

Use O24.313 When
  • Follow the official ICD
  • CM guidelines for coding diabetes in pregnancy, ensuring that the specific trimester is documented and that any complications are coded appropriately
  • Use additional codes for complications if applicable

Exclusion Criteria

Do NOT use O24.313 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 a patient with pre-existing diabetes in pregnancy.

Documentation Requirements

Document the patient's diabetes management, any changes in treatment, and fetal monitoring results.

Specialty Considerations

Ensure that the visit reflects the complexity of managing diabetes 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 diabetes in pregnancy, improving the ability to track and manage these conditions effectively. O24.313 provides a clear distinction for pre-existing diabetes, which aids in clinical management and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of diabetes in pregnancy, improving the ability to track and manage these conditions effectively. O24.313 provides a clear distinction for pre-existing diabetes, which aids in clinical management and research.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of diabetes in pregnancy, improving the ability to track and manage these conditions effectively. O24.313 provides a clear distinction for pre-existing diabetes, which aids in clinical management and research.

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 that was diagnosed before pregnancy, while gestational diabetes develops during pregnancy. Accurate coding is essential to reflect the patient's condition and management needs.