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v1.0.0
ICD-10 Guide
ICD-10 CodesO12.12

O12.12

Billable

Gestational proteinuria, second trimester

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

Code Description

ICD-10 O12.12 is a billable code used to indicate a diagnosis of gestational proteinuria, second trimester.

Key Diagnostic Point:

Gestational proteinuria refers to the presence of excess protein in the urine during pregnancy, specifically occurring in the second trimester. This condition is often associated with gestational edema, which is the swelling caused by fluid retention. Unlike preeclampsia, gestational proteinuria without hypertension does not involve elevated blood pressure. The presence of proteinuria can indicate underlying issues with kidney function or placental health, necessitating careful monitoring. Clinicians typically assess protein levels through urine tests, and the condition may resolve after delivery. Management focuses on monitoring the mother and fetus, ensuring that both remain healthy throughout the pregnancy. It is crucial for healthcare providers to differentiate between gestational proteinuria and other hypertensive disorders of pregnancy to avoid misdiagnosis and ensure appropriate care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other hypertensive disorders of pregnancy.
  • Need for accurate urine protein quantification.
  • Monitoring for potential progression to preeclampsia.
  • Documentation of gestational age and trimester.

Audit Risk Factors

  • Inadequate documentation of proteinuria testing.
  • Failure to note absence of hypertension.
  • Misclassification of gestational proteinuria as preeclampsia.
  • Lack of follow-up documentation on maternal and fetal health.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of urine protein levels, maternal symptoms, and any interventions.

Common Clinical Scenarios

Routine prenatal visits where proteinuria is detected during urinalysis.

Billing Considerations

Ensure clear documentation of the absence of hypertension to avoid misdiagnosis.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive assessment of maternal and fetal health, including ultrasound findings.

Common Clinical Scenarios

Management of high-risk pregnancies with proteinuria and potential complications.

Billing Considerations

Close monitoring for signs of progression to preeclampsia or other complications.

Coding Guidelines

Inclusion Criteria

Use O12.12 When
  • Follow the official ICD
  • CM guidelines for coding pregnancy
  • related conditions, ensuring accurate documentation of gestational age and specific symptoms
  • Use additional codes as necessary to capture any related conditions

Exclusion Criteria

Do NOT use O12.12 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

81002CPT Code

Urinalysis, automated, with microscopy

Clinical Scenario

Used to assess protein levels in urine during routine prenatal visits.

Documentation Requirements

Document the reason for urinalysis and results of protein levels.

Specialty Considerations

Ensure proper coding for the type of urinalysis performed.

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 accuracy of diagnoses and facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of gestational conditions, improving the accuracy of diagnoses and facilitating better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of gestational conditions, improving the accuracy of diagnoses and facilitating better patient management.

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 gestational proteinuria?

Gestational proteinuria can indicate potential complications in pregnancy, such as preeclampsia, and requires careful monitoring to ensure the health of both mother and fetus.