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ICD-10 Guide
ICD-10 CodesO24.913

O24.913

Billable

Unspecified diabetes mellitus in pregnancy, third trimester

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

Code Description

ICD-10 O24.913 is a billable code used to indicate a diagnosis of unspecified diabetes mellitus in pregnancy, third trimester.

Key Diagnostic Point:

Unspecified diabetes mellitus in pregnancy during the third trimester refers to a condition where a pregnant woman experiences elevated blood glucose levels that do not meet the criteria for gestational diabetes but still require monitoring and management. This condition can pose risks to both the mother and fetus, including macrosomia, preeclampsia, and increased likelihood of cesarean delivery. Management typically involves dietary modifications, blood glucose monitoring, and potentially insulin therapy to maintain optimal glucose levels. Fetal monitoring is crucial during this period to assess fetal growth and well-being, as uncontrolled diabetes can lead to complications such as fetal distress or stillbirth. Regular follow-ups with healthcare providers are essential to adjust treatment plans as needed and ensure both maternal and fetal health are prioritized.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in blood glucose monitoring protocols
  • Need for individualized insulin management plans
  • Potential for coexisting conditions (e.g., hypertension)
  • Documentation of fetal monitoring and growth assessments

Audit Risk Factors

  • Inadequate documentation of blood glucose levels
  • Failure to document insulin management plans
  • Lack of fetal monitoring records
  • Misclassification of diabetes type

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of maternal glucose levels, insulin dosages, and dietary modifications.

Common Clinical Scenarios

Management of diabetes in pregnant patients, monitoring for complications, and planning for delivery.

Billing Considerations

Ensure clear documentation of the patient's diabetes management plan and any changes in treatment.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive assessments of maternal-fetal health, including ultrasound findings and growth parameters.

Common Clinical Scenarios

High-risk pregnancies with diabetes, requiring multidisciplinary management.

Billing Considerations

Focus on the implications of diabetes on fetal development and the need for specialized care.

Coding Guidelines

Inclusion Criteria

Use O24.913 When
  • Follow the official ICD
  • CM guidelines for coding diabetes in pregnancy, ensuring accurate documentation of the type of diabetes and its management
  • Specific criteria for gestational diabetes must be distinguished from unspecified diabetes

Exclusion Criteria

Do NOT use O24.913 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, moderate complexity

Clinical Scenario

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

Documentation Requirements

Document patient history, examination findings, and management plans.

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 accuracy of data collection and reimbursement processes. It emphasizes the importance of detailed documentation and management strategies.

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. It emphasizes the importance of detailed documentation and management strategies.

Reimbursement & Billing Impact

reimbursement processes. It emphasizes the importance of detailed documentation and management strategies.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What is the difference between unspecified diabetes and gestational diabetes?

Unspecified diabetes refers to elevated blood glucose levels that do not meet the criteria for gestational diabetes, while gestational diabetes is diagnosed based on specific glucose tolerance tests during pregnancy. Management strategies may differ significantly.