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ICD-10 Guide
ICD-10 CodesO14.03

O14.03

Billable

Mild to moderate pre-eclampsia, third trimester

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

Code Description

ICD-10 O14.03 is a billable code used to indicate a diagnosis of mild to moderate pre-eclampsia, third trimester.

Key Diagnostic Point:

Mild to moderate pre-eclampsia is a pregnancy complication characterized by hypertension and proteinuria occurring after 20 weeks of gestation. In the third trimester, it is crucial to monitor the mother and fetus closely due to the potential for progression to severe pre-eclampsia or eclampsia. Symptoms may include elevated blood pressure (systolic ≥ 140 mmHg or diastolic ≥ 90 mmHg), protein in the urine, and possible swelling. Management typically involves close monitoring, lifestyle modifications, and potentially the use of antihypertensive medications. Magnesium sulfate may be administered to prevent seizures, especially if there are signs of severe features. The condition requires careful documentation of blood pressure readings, urine protein levels, and any symptoms experienced by the patient to ensure appropriate coding and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between mild, moderate, and severe pre-eclampsia
  • Monitoring for progression to HELLP syndrome
  • Documentation of maternal and fetal assessments
  • Understanding magnesium sulfate protocols and indications

Audit Risk Factors

  • Inadequate documentation of blood pressure readings
  • Failure to document proteinuria accurately
  • Misclassification of pre-eclampsia severity
  • Lack of follow-up notes on maternal and fetal health

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of blood pressure, proteinuria, and symptoms are essential. Regular assessments and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with elevated blood pressure and proteinuria during routine prenatal visits.

Billing Considerations

Ensure that all assessments are time-stamped and include the patient's gestational age.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including previous history of pre-eclampsia and current maternal and fetal assessments.

Common Clinical Scenarios

Management of patients with a history of severe pre-eclampsia or those presenting with new-onset hypertension.

Billing Considerations

Close monitoring for signs of HELLP syndrome and timely intervention documentation.

Coding Guidelines

Inclusion Criteria

Use O14.03 When
  • Follow the official ICD
  • CM guidelines for coding pregnancy
  • related conditions, ensuring that the diagnosis is supported by clinical documentation
  • Specific criteria for pre
  • eclampsia include blood pressure readings and proteinuria levels

Exclusion Criteria

Do NOT use O14.03 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, level 3

Clinical Scenario

Used for routine prenatal visits where mild pre-eclampsia is monitored.

Documentation Requirements

Document blood pressure readings, urine protein levels, and any symptoms.

Specialty Considerations

Obstetricians should ensure that all relevant assessments are included in the visit notes.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of pregnancy-related conditions, improving the accuracy of diagnoses and treatment plans. O14.03 provides a clear distinction between mild and moderate pre-eclampsia, enhancing clinical management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of pregnancy-related conditions, improving the accuracy of diagnoses and treatment plans. O14.03 provides a clear distinction between mild and moderate pre-eclampsia, enhancing clinical management.

Reimbursement & Billing Impact

reimbursement and compliance.

Resources

Clinical References

  • •
    ACOG Practice Bulletin on Hypertension in Pregnancy

Coding & Billing References

  • •
    ACOG Practice Bulletin on Hypertension in Pregnancy

Frequently Asked Questions

What are the signs of mild to moderate pre-eclampsia?

Signs include elevated blood pressure, proteinuria, swelling, headaches, and visual disturbances. Regular monitoring is essential for early detection and management.