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ICD-10 Guide
ICD-10 CodesO24.812

O24.812

Billable

Other pre-existing diabetes mellitus in pregnancy, second trimester

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

Code Description

ICD-10 O24.812 is a billable code used to indicate a diagnosis of other pre-existing diabetes mellitus in pregnancy, second trimester.

Key Diagnostic Point:

O24.812 refers to cases where a patient has pre-existing diabetes mellitus that is not classified as type 1 or type 2 and is experiencing this condition during the second trimester of pregnancy. This code is crucial for identifying patients who may require specialized management due to their diabetes status. Women with pre-existing diabetes are at increased risk for complications such as fetal macrosomia, preeclampsia, and cesarean delivery. Management typically involves close monitoring of blood glucose levels, dietary modifications, and possibly insulin therapy to maintain optimal glycemic control. Fetal monitoring is also essential to assess fetal growth and well-being, as well as to detect any potential complications early. The second trimester is a critical period for both maternal and fetal health, necessitating a multidisciplinary approach to care that includes obstetricians, endocrinologists, and dietitians.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of diabetes mellitus
  • Understanding the implications of diabetes on pregnancy outcomes
  • Managing insulin therapy and dietary needs
  • Monitoring fetal growth and development

Audit Risk Factors

  • Inadequate documentation of diabetes management
  • Failure to document fetal monitoring results
  • Misclassification of diabetes type
  • Lack of interdisciplinary communication notes

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of maternal health, diabetes management plans, and fetal monitoring results.

Common Clinical Scenarios

Patients with pre-existing diabetes presenting for routine prenatal care, requiring adjustments in management as pregnancy progresses.

Billing Considerations

Ensure accurate coding based on the type of diabetes and trimester; monitor for complications.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including maternal diabetes management and fetal assessments.

Common Clinical Scenarios

High-risk pregnancies with pre-existing diabetes requiring specialized monitoring and interventions.

Billing Considerations

Focus on the potential for complications and the need for a tailored care plan.

Coding Guidelines

Inclusion Criteria

Use O24.812 When
  • Follow the ICD
  • CM guidelines for coding diabetes in pregnancy, ensuring that the specific trimester is documented and that the type of diabetes is accurately classified

Exclusion Criteria

Do NOT use O24.812 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 patients with pre-existing diabetes during pregnancy.

Documentation Requirements

Document the patient's diabetes management, including blood glucose levels and any changes in treatment.

Specialty Considerations

Obstetricians should coordinate with endocrinologists for comprehensive 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 for care provided.

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 for care provided.

Reimbursement & Billing Impact

reimbursement for care provided.

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 and typically resolves after delivery. Accurate coding is essential to reflect the patient's condition.