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v1.0.0
ICD-10 Guide
ICD-10 CodesO26.22

O26.22

Billable

Pregnancy care for patient with recurrent pregnancy loss, second trimester

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

Code Description

ICD-10 O26.22 is a billable code used to indicate a diagnosis of pregnancy care for patient with recurrent pregnancy loss, second trimester.

Key Diagnostic Point:

O26.22 is used to indicate pregnancy care for patients experiencing recurrent pregnancy loss during the second trimester. This condition is characterized by the loss of two or more pregnancies before the 20th week of gestation. In the second trimester, the focus of care shifts to monitoring the health of both the mother and the fetus, addressing any underlying conditions that may contribute to pregnancy loss. Maternal care may involve managing chronic conditions such as renal, cardiac, or respiratory issues that can complicate pregnancy. For instance, renal conditions may require careful monitoring of fluid balance and electrolyte levels, while cardiac conditions necessitate a multidisciplinary approach to ensure maternal and fetal safety. Respiratory issues may require adjustments in medication and monitoring of oxygen levels. The goal of care is to provide a supportive environment that maximizes the chances of a successful pregnancy outcome while addressing the complexities introduced by the mother's health status.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Multiple underlying maternal health conditions (renal, cardiac, respiratory)
  • Need for multidisciplinary care coordination
  • Variability in clinical presentation and management strategies
  • Documentation of recurrent pregnancy loss and its implications

Audit Risk Factors

  • Inadequate documentation of recurrent pregnancy loss
  • Failure to document maternal comorbidities
  • Misclassification of the trimester of pregnancy
  • Lack of clear treatment plans for underlying conditions

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of pregnancy history, including previous losses, current pregnancy status, and any interventions.

Common Clinical Scenarios

Management of a patient with a history of recurrent pregnancy loss presenting for routine prenatal care.

Billing Considerations

Ensure all maternal health conditions are documented and linked to the pregnancy care plan.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including maternal health conditions and their management.

Common Clinical Scenarios

Consultation for a patient with recurrent pregnancy loss and significant cardiac history.

Billing Considerations

Focus on the multidisciplinary approach and coordination of care among specialists.

Coding Guidelines

Inclusion Criteria

Use O26.22 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the patient's history of recurrent pregnancy loss and any complicating maternal conditions
  • Ensure that the code reflects the current trimester and any relevant complications

Exclusion Criteria

Do NOT use O26.22 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59400CPT Code

Obstetric care including antepartum care, delivery, and postpartum care

Clinical Scenario

Used for comprehensive care of a patient with recurrent pregnancy loss during the second trimester.

Documentation Requirements

Document all prenatal visits, assessments, and any interventions.

Specialty Considerations

Ensure coordination with maternal-fetal medicine specialists if applicable.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of recurrent pregnancy loss and associated maternal conditions, improving the accuracy of data collection and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of recurrent pregnancy loss and associated maternal conditions, improving the accuracy of data collection and reimbursement.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What documentation is required for coding O26.22?

Documentation must include a detailed history of recurrent pregnancy loss, current pregnancy status, and any maternal health conditions that may complicate the pregnancy. All relevant clinical findings and treatment plans should be clearly recorded.