Excessive vomiting in pregnancy
Chapter 15:Pregnancy, childbirth and the puerperium
ICD-10 O21 is a billable code used to indicate a diagnosis of excessive vomiting in pregnancy.
Excessive vomiting in pregnancy, commonly referred to as hyperemesis gravidarum, is a severe form of nausea and vomiting that occurs during pregnancy. It is characterized by persistent vomiting that can lead to dehydration, electrolyte imbalances, and nutritional deficiencies. This condition typically arises in the first trimester but can persist throughout pregnancy. Patients may experience weight loss, ketonuria, and an inability to maintain adequate hydration or nutrition. Management often requires hospitalization for intravenous fluids, electrolyte replacement, and nutritional support, including the use of antiemetic medications. The condition can significantly impact the quality of life and may necessitate close monitoring of both maternal and fetal health. Accurate diagnosis and coding are essential for appropriate treatment and reimbursement.
Documentation must include the frequency and severity of vomiting, weight changes, and any interventions provided.
Patients presenting with severe nausea and vomiting requiring hospitalization for IV fluids and antiemetics.
Consideration of the patient's overall health, including pre-existing conditions that may complicate treatment.
Detailed documentation of maternal and fetal monitoring, including any complications arising from hyperemesis.
High-risk pregnancies where hyperemesis gravidarum may affect fetal growth and maternal health.
Close monitoring of nutritional status and potential impact on fetal development.
Used when a patient with hyperemesis gravidarum is admitted for IV hydration and monitoring.
Document the patient's history, examination findings, and treatment plan.
Obstetricians should ensure that all relevant symptoms and treatments are documented to support the level of care billed.
O21.0 is used when hyperemesis gravidarum is accompanied by metabolic disturbance, indicating more severe dehydration and electrolyte imbalance, while O21.1 is for cases without metabolic disturbance.
