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ICD-10 Guide
ICD-10 CodesO24.919

O24.919

Billable

Unspecified diabetes mellitus in pregnancy, unspecified trimester

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

Code Description

ICD-10 O24.919 is a billable code used to indicate a diagnosis of unspecified diabetes mellitus in pregnancy, unspecified trimester.

Key Diagnostic Point:

Unspecified diabetes mellitus in pregnancy refers to a condition where a pregnant woman has diabetes that is not clearly defined as either pre-existing or gestational diabetes. This condition can occur at any point during pregnancy and may require careful management to ensure the health of both the mother and the fetus. Diabetes in pregnancy can lead to various complications, including macrosomia, preterm birth, and increased risk of cesarean delivery. Insulin management is often necessary, as blood glucose levels must be closely monitored and controlled to prevent adverse outcomes. Fetal monitoring is also critical, as it helps assess the well-being of the fetus and detect any potential complications early. The unspecified trimester designation indicates that the exact timing of the diagnosis within the pregnancy is not documented, which can complicate management and coding. Proper documentation is essential to ensure appropriate care and coding accuracy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Lack of specificity regarding the type of diabetes (gestational vs. pre-existing)
  • Variability in insulin management protocols based on individual patient needs
  • Need for continuous fetal monitoring and assessment
  • Potential for complications requiring additional coding

Audit Risk Factors

  • Inadequate documentation of diabetes management plans
  • Failure to specify the trimester of pregnancy
  • Lack of clear differentiation between gestational and pre-existing diabetes
  • Insufficient fetal monitoring records

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include details on the type of diabetes, management strategies, and fetal monitoring results.

Common Clinical Scenarios

Patients diagnosed with diabetes during routine prenatal visits, requiring dietary modifications and insulin therapy.

Billing Considerations

Coders should ensure that all relevant clinical details are captured to support the diagnosis and management of diabetes in pregnancy.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancy documentation must include comprehensive assessments of maternal and fetal health, including glucose monitoring and insulin administration.

Common Clinical Scenarios

Complex cases involving multiple comorbidities and the need for specialized care.

Billing Considerations

High-risk coding requires attention to detail and thorough documentation to justify the complexity of care provided.

Coding Guidelines

Inclusion Criteria

Use O24.919 When
  • According to ICD
  • 10 coding guidelines, it is essential to document the type of diabetes and the trimester of pregnancy
  • If the type of diabetes is not specified, O24
  • 919 is appropriate
  • Coders should also be aware of the need for additional codes to capture any complications arising from diabetes in pregnancy

Exclusion Criteria

Do NOT use O24.919 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 diabetes management during pregnancy.

Documentation Requirements

Documentation must include assessment of blood glucose levels and management plan.

Specialty Considerations

Obstetricians should document any changes in insulin therapy or dietary recommendations.

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. However, it has also introduced complexity, requiring coders to be more diligent in documentation and coding practices.

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. However, it has also introduced complexity, requiring coders to be more diligent in documentation and coding practices.

Reimbursement & Billing Impact

reimbursement. However, it has also introduced complexity, requiring coders to be more diligent in documentation and coding practices.

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 gestational diabetes and unspecified diabetes in pregnancy?

Gestational diabetes is a specific diagnosis that occurs during pregnancy, while unspecified diabetes in pregnancy does not clarify whether the diabetes is pre-existing or gestational. Accurate documentation is crucial for appropriate coding and management.