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ICD-10 Guide
ICD-10 CodesO13.4

O13.4

Billable

Gestational [pregnancy-induced] hypertension without significant proteinuria, complicating childbirth

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

Code Description

ICD-10 O13.4 is a billable code used to indicate a diagnosis of gestational [pregnancy-induced] hypertension without significant proteinuria, complicating childbirth.

Key Diagnostic Point:

Gestational hypertension, also known as pregnancy-induced hypertension, is a condition characterized by elevated blood pressure that develops after 20 weeks of gestation in a previously normotensive woman. This condition is significant as it can lead to complications for both the mother and the fetus if not monitored and managed appropriately. In cases classified under O13.4, the hypertension occurs without significant proteinuria, which differentiates it from preeclampsia. Monitoring blood pressure is crucial during labor and delivery, as uncontrolled hypertension can lead to serious outcomes such as placental abruption, fetal distress, and maternal complications. Management may include lifestyle modifications, medication, and close monitoring of both maternal and fetal health. Accurate coding is essential to reflect the complexity of care provided and to ensure appropriate reimbursement for services rendered.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between gestational hypertension and preeclampsia.
  • Monitoring and documenting blood pressure readings accurately.
  • Understanding the implications of hypertension on labor and delivery.
  • Navigating the nuances of associated conditions and complications.

Audit Risk Factors

  • Inadequate documentation of blood pressure readings.
  • Failure to note the absence of proteinuria.
  • Misclassification of gestational hypertension as preeclampsia.
  • Lack of clarity in the management plan for hypertension.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of blood pressure readings, maternal symptoms, and fetal monitoring.

Common Clinical Scenarios

A patient presenting with elevated blood pressure during labor without proteinuria.

Billing Considerations

Ensure that all relevant clinical findings are documented to support the diagnosis and management plan.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including previous hypertensive disorders.

Common Clinical Scenarios

Management of a high-risk pregnancy with gestational hypertension requiring specialized monitoring.

Billing Considerations

Consideration of additional diagnostic tests and interventions that may be necessary for high-risk patients.

Coding Guidelines

Inclusion Criteria

Use O13.4 When
  • Follow the official ICD
  • CM coding guidelines for obstetric conditions, ensuring that the diagnosis is supported by clinical documentation and that the appropriate code is selected based on the presence or absence of proteinuria

Exclusion Criteria

Do NOT use O13.4 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99203CPT Code

Office or other outpatient visit for the evaluation and management of a new patient

Clinical Scenario

Used during routine prenatal visits for monitoring gestational hypertension.

Documentation Requirements

Document blood pressure readings, patient history, and any interventions.

Specialty Considerations

Obstetricians should ensure that all relevant clinical information is captured.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of gestational hypertension, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of documenting the absence of proteinuria and the management of hypertension during pregnancy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of gestational hypertension, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of documenting the absence of proteinuria and the management of hypertension during pregnancy.

Reimbursement & Billing Impact

reimbursement processes. It emphasizes the importance of documenting the absence of proteinuria and the management of hypertension during pregnancy.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What is the difference between gestational hypertension and preeclampsia?

Gestational hypertension is characterized by high blood pressure without significant proteinuria, while preeclampsia involves high blood pressure with significant proteinuria and may present additional risks for both mother and baby.