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ICD-10 Guide
ICD-10 CodesO14.93

O14.93

Billable

Unspecified pre-eclampsia, third trimester

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

Code Description

ICD-10 O14.93 is a billable code used to indicate a diagnosis of unspecified pre-eclampsia, third trimester.

Key Diagnostic Point:

Unspecified pre-eclampsia is a condition that occurs during pregnancy, typically after the 20th week, characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys. In the third trimester, the risk of complications increases significantly, necessitating careful monitoring and management. Pre-eclampsia can progress to severe features, which may include severe hypertension, proteinuria, and symptoms such as headaches, visual disturbances, and upper abdominal pain. HELLP syndrome, a severe form of pre-eclampsia, involves hemolysis, elevated liver enzymes, and low platelet count, requiring immediate medical intervention. Magnesium sulfate is commonly administered to prevent seizures in women with severe pre-eclampsia or eclampsia. The management of pre-eclampsia involves close monitoring of maternal and fetal well-being, with potential interventions including antihypertensive medications and early delivery if the condition worsens. Accurate coding of this condition is crucial for appropriate treatment and reimbursement.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between mild and severe pre-eclampsia
  • Identifying associated conditions like HELLP syndrome
  • Understanding the implications of magnesium sulfate administration
  • Navigating documentation requirements for high-risk pregnancies

Audit Risk Factors

  • Inadequate documentation of blood pressure readings
  • Failure to note the presence of severe features or HELLP syndrome
  • Lack of clarity on the administration of magnesium sulfate
  • Insufficient follow-up documentation on maternal and fetal outcomes

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of blood pressure, proteinuria, and any symptoms indicative of severe pre-eclampsia.

Common Clinical Scenarios

Management of a pregnant patient presenting with elevated blood pressure and proteinuria in the third trimester.

Billing Considerations

Ensure all relevant symptoms and treatments are documented to support the diagnosis.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of maternal and fetal assessments, including ultrasound findings and laboratory results.

Common Clinical Scenarios

Monitoring and managing a high-risk pregnancy with severe pre-eclampsia and potential HELLP syndrome.

Billing Considerations

Focus on the multidisciplinary approach to care and the need for timely interventions.

Coding Guidelines

Inclusion Criteria

Use O14.93 When
  • Follow the official ICD
  • CM guidelines for coding obstetric conditions, ensuring that the diagnosis is supported by clinical documentation
  • Specific criteria for pre
  • eclampsia include blood pressure readings and laboratory findings indicative of organ dysfunction

Exclusion Criteria

Do NOT use O14.93 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59400CPT Code

Obstetrical care including antepartum care, delivery, and postpartum care

Clinical Scenario

Used for comprehensive care of a patient diagnosed with pre-eclampsia.

Documentation Requirements

Document all visits, assessments, and interventions related to pre-eclampsia management.

Specialty Considerations

Ensure that all aspects of care are captured, especially in high-risk scenarios.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of pre-eclampsia, improving the accuracy of diagnosis and treatment tracking. This specificity aids in better patient management and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of pre-eclampsia, improving the accuracy of diagnosis and treatment tracking. This specificity aids in better patient management and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 unspecified pre-eclampsia and severe pre-eclampsia?

Unspecified pre-eclampsia (O14.93) lacks detailed documentation of severe features, while severe pre-eclampsia (O14.2) includes specific symptoms such as significantly elevated blood pressure and organ dysfunction.