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ICD-10 Guide
ICD-10 CodesO12.10

O12.10

Billable

Gestational proteinuria, unspecified trimester

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

Code Description

ICD-10 O12.10 is a billable code used to indicate a diagnosis of gestational proteinuria, unspecified trimester.

Key Diagnostic Point:

Gestational proteinuria refers to the presence of excess protein in the urine during pregnancy, which can be a sign of underlying health issues. This condition is typically identified through routine urinalysis during prenatal visits. In the absence of hypertension, gestational proteinuria may be associated with gestational edema, which is the swelling caused by fluid retention. While proteinuria can indicate potential complications, such as preeclampsia, the unspecified trimester designation means that the timing of the diagnosis within the pregnancy is not clearly defined. Clinicians must monitor the patient closely for any signs of hypertension or other complications, as the presence of proteinuria alone does not necessarily indicate a severe condition. Management may include dietary modifications, increased hydration, and regular monitoring of kidney function and overall health. Accurate coding is essential to ensure appropriate care and reimbursement, as well as to track maternal and fetal health outcomes effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between gestational proteinuria and other types of proteinuria.
  • Determining the absence of hypertension to avoid misclassification.
  • Identifying the appropriate trimester for coding when unspecified.
  • Understanding the implications of gestational edema in relation to proteinuria.

Audit Risk Factors

  • Inadequate documentation of proteinuria levels.
  • Failure to document the absence of hypertension.
  • Misclassification of the trimester.
  • Lack of follow-up notes regarding the patient's condition.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed prenatal visit notes, including urinalysis results and any symptoms of edema.

Common Clinical Scenarios

Routine prenatal visits where proteinuria is detected without hypertension.

Billing Considerations

Ensure clear documentation of the absence of hypertension and any related symptoms.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive records of high-risk assessments and monitoring protocols.

Common Clinical Scenarios

Management of patients with gestational proteinuria in high-risk pregnancies.

Billing Considerations

Focus on the potential for progression to preeclampsia and the need for close monitoring.

Coding Guidelines

Inclusion Criteria

Use O12.10 When
  • Follow the official ICD
  • CM coding guidelines for obstetric conditions, ensuring that the diagnosis is supported by clinical documentation and that the absence of hypertension is clearly noted

Exclusion Criteria

Do NOT use O12.10 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

81002CPT Code

Urinalysis, automated, with microscopy

Clinical Scenario

Used during routine prenatal visits to assess for proteinuria.

Documentation Requirements

Document the urinalysis results and any follow-up actions taken.

Specialty Considerations

Ensure that the urinalysis is performed in accordance with obstetric guidelines.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of gestational conditions, improving the ability to track and manage pregnancy-related complications. O12.10 provides a clear designation for cases of proteinuria without hypertension, which aids in clinical decision-making and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of gestational conditions, improving the ability to track and manage pregnancy-related complications. O12.10 provides a clear designation for cases of proteinuria without hypertension, which aids in clinical decision-making and research.

Reimbursement & Billing Impact

reimbursement and quality care tracking.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of coding O12.10?

Coding O12.10 is significant as it helps identify cases of gestational proteinuria without hypertension, allowing for appropriate monitoring and management of the condition to prevent complications.