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ICD-10 Guide
ICD-10 CodesO26.64

O26.64

Billable

Intrahepatic cholestasis of pregnancy

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

Code Description

ICD-10 O26.64 is a billable code used to indicate a diagnosis of intrahepatic cholestasis of pregnancy.

Key Diagnostic Point:

Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder that occurs during pregnancy, characterized by intense itching and elevated bile acids in the maternal bloodstream. It typically arises in the third trimester and is associated with increased risks for both the mother and fetus, including preterm birth and fetal distress. The exact etiology remains unclear, but it is believed to involve hormonal changes and genetic predisposition. Maternal symptoms often include pruritus, particularly on the palms and soles, and may be accompanied by jaundice in severe cases. Diagnosis is confirmed through elevated serum bile acids and liver function tests. Management focuses on symptom relief and monitoring fetal well-being, with potential interventions including ursodeoxycholic acid to reduce bile acid levels and improve maternal symptoms. Close monitoring of fetal heart rate and gestational age is essential to mitigate risks associated with ICP, making it a significant condition in obstetric care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in symptom presentation among patients
  • Need for comprehensive liver function testing
  • Potential for co-occurring conditions (e.g., gestational diabetes)
  • Management strategies may vary based on severity

Audit Risk Factors

  • Inadequate documentation of symptoms and lab results
  • Failure to document fetal monitoring and interventions
  • Misclassification of severity of the condition
  • Lack of follow-up documentation post-diagnosis

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of maternal symptoms, lab results, and treatment plans is essential for accurate coding.

Common Clinical Scenarios

Patients presenting with itching and elevated bile acids, requiring monitoring and potential intervention.

Billing Considerations

Consideration of the timing of symptoms in relation to gestational age and potential impacts on delivery.

Maternal-Fetal Medicine

Documentation Requirements

Thorough documentation of high-risk factors, including maternal history and fetal assessments.

Common Clinical Scenarios

Management of high-risk pregnancies with ICP, including close monitoring and potential early delivery.

Billing Considerations

Coordination with obstetricians for comprehensive care and documentation of multidisciplinary approaches.

Coding Guidelines

Inclusion Criteria

Use O26.64 When
  • 10 coding guidelines for obstetric conditions emphasize the importance of specificity in documenting the condition, including the trimester of pregnancy and any associated complications
  • Accurate coding requires adherence to the guidelines set forth by the American Academy of Professional Coders (AAPC) and the Centers for Medicare & Medicaid Services (CMS)

Exclusion Criteria

Do NOT use O26.64 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits for monitoring ICP and managing symptoms.

Documentation Requirements

Documentation must include assessment of symptoms, lab results, and treatment plans.

Specialty Considerations

Obstetricians should ensure comprehensive documentation of maternal and fetal assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like intrahepatic cholestasis of pregnancy, improving the accuracy of data collection and reimbursement processes. The granularity of ICD-10 codes facilitates better tracking of maternal and fetal outcomes associated with ICP.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like intrahepatic cholestasis of pregnancy, improving the accuracy of data collection and reimbursement processes. The granularity of ICD-10 codes facilitates better tracking of maternal and fetal outcomes associated with ICP.

Reimbursement & Billing Impact

reimbursement processes. The granularity of ICD-10 codes facilitates better tracking of maternal and fetal outcomes associated with ICP.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What are the common symptoms of intrahepatic cholestasis of pregnancy?

Common symptoms include intense itching, particularly on the palms and soles, and in some cases, jaundice. These symptoms typically arise in the third trimester and can significantly impact maternal comfort and fetal health.