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ICD-10 Guide
ICD-10 CodesO14.05

O14.05

Billable

Mild to moderate pre-eclampsia, complicating the puerperium

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

Code Description

ICD-10 O14.05 is a billable code used to indicate a diagnosis of mild to moderate pre-eclampsia, complicating the puerperium.

Key Diagnostic Point:

Mild to moderate pre-eclampsia is a hypertensive disorder that occurs during pregnancy and can persist into the puerperium, which is the period following childbirth. This condition is characterized by elevated blood pressure and the presence of protein in the urine after 20 weeks of gestation. In the puerperium, it can lead to complications such as persistent hypertension, renal impairment, and increased risk of cardiovascular issues. Management typically involves monitoring blood pressure, administering antihypertensive medications, and in some cases, magnesium sulfate to prevent seizures. The condition requires careful documentation of maternal blood pressure readings, urine protein levels, and any interventions performed. The transition from pregnancy to the postpartum period necessitates ongoing assessment to ensure maternal safety and health, as the risk of complications can remain elevated even after delivery.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between mild and severe pre-eclampsia
  • Understanding the implications of HELLP syndrome
  • Monitoring and documenting magnesium sulfate administration
  • Managing co-existing conditions that may complicate coding

Audit Risk Factors

  • Inadequate documentation of blood pressure readings
  • Failure to document the duration of symptoms
  • Misclassification of pre-eclampsia severity
  • Omission of magnesium sulfate administration details

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of maternal blood pressure, urine protein levels, and treatment protocols.

Common Clinical Scenarios

Management of a patient with mild pre-eclampsia during the postpartum period requiring antihypertensive therapy.

Billing Considerations

Ensure accurate coding of the severity of pre-eclampsia and any related complications.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, fetal monitoring, and maternal health status.

Common Clinical Scenarios

Monitoring a patient with a history of pre-eclampsia during subsequent pregnancies.

Billing Considerations

Focus on the implications of pre-eclampsia for future pregnancies and maternal health.

Coding Guidelines

Inclusion Criteria

Use O14.05 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 severity of pre
  • eclampsia

Exclusion Criteria

Do NOT use O14.05 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99233CPT Code

Subsequent hospital care, typically 15-29 minutes

Clinical Scenario

Used for follow-up visits for a patient with mild pre-eclampsia in the postpartum period.

Documentation Requirements

Document the patient's blood pressure, symptoms, and treatment plan.

Specialty Considerations

Ensure that the visit is clearly linked to the management of pre-eclampsia.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the accuracy of data collection and reimbursement processes for conditions like pre-eclampsia.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the accuracy of data collection and reimbursement processes for conditions like pre-eclampsia.

Reimbursement & Billing Impact

reimbursement processes for conditions like pre-eclampsia.

Resources

Clinical References

  • •
    ACOG Practice Bulletin on Hypertension in Pregnancy

Coding & Billing References

  • •
    ACOG Practice Bulletin on Hypertension in Pregnancy

Frequently Asked Questions

What is the difference between mild and severe pre-eclampsia?

Mild pre-eclampsia is characterized by blood pressure readings of 140/90 mmHg or higher and proteinuria, while severe pre-eclampsia involves higher blood pressure readings (160/110 mmHg or higher) and may include additional symptoms such as severe headaches, visual disturbances, or liver dysfunction.