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ICD-10 Guide
ICD-10 CodesO12.14

O12.14

Billable

Gestational proteinuria, complicating childbirth

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

Code Description

ICD-10 O12.14 is a billable code used to indicate a diagnosis of gestational proteinuria, complicating childbirth.

Key Diagnostic Point:

Gestational proteinuria refers to the presence of excess protein in the urine during pregnancy, specifically occurring in the context of childbirth. This condition is characterized by the development of proteinuria without accompanying hypertension, distinguishing it from preeclampsia. It is often associated with gestational edema, which is the accumulation of fluid in the body's tissues, leading to swelling. The presence of proteinuria can indicate underlying renal issues or may be a benign finding in some cases. Clinically, it is important to monitor protein levels and assess for any potential complications that may arise during labor and delivery. Management typically involves careful monitoring of the mother and fetus, ensuring that both are stable throughout the childbirth process. The diagnosis of gestational proteinuria is made through urinalysis, and it is crucial for healthcare providers to document the findings accurately to ensure appropriate coding and billing. This condition may require additional follow-up postpartum to ensure resolution and to rule out any chronic kidney issues.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other hypertensive disorders of pregnancy.
  • Need for accurate urinalysis documentation.
  • Monitoring for potential complications during labor.
  • Understanding of gestational vs. chronic conditions.

Audit Risk Factors

  • Inadequate documentation of urinalysis results.
  • Failure to differentiate from preeclampsia.
  • Misclassification of gestational proteinuria severity.
  • Lack of follow-up documentation postpartum.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of urinalysis, maternal symptoms, and fetal monitoring.

Common Clinical Scenarios

Patients presenting with edema and proteinuria during labor without hypertension.

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 risk factors for complications.

Common Clinical Scenarios

High-risk pregnancies with gestational proteinuria requiring specialized monitoring.

Billing Considerations

Focus on potential renal implications and the need for multidisciplinary care.

Coding Guidelines

Inclusion Criteria

Use O12.14 When
  • Follow the official ICD
  • CM guidelines for coding obstetric conditions, ensuring that gestational proteinuria is documented accurately and that any associated conditions are coded appropriately
  • Use additional codes as necessary to capture the full clinical picture

Exclusion Criteria

Do NOT use O12.14 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 prenatal visits.

Documentation Requirements

Document urinalysis results and any symptoms reported by the patient.

Specialty Considerations

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

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. O12.14 provides a clear distinction from other hypertensive disorders, aiding in appropriate treatment pathways.

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. O12.14 provides a clear distinction from other hypertensive disorders, aiding in appropriate treatment pathways.

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. O12.14 provides a clear distinction from other hypertensive disorders, aiding in appropriate treatment pathways.

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 difference between gestational proteinuria and preeclampsia?

Gestational proteinuria occurs without hypertension, while preeclampsia is characterized by both proteinuria and elevated blood pressure. Accurate diagnosis is crucial for appropriate management.