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ICD-10 Guide
ICD-10 CodesO22.31

O22.31

Billable

Deep phlebothrombosis in pregnancy, first trimester

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

Code Description

ICD-10 O22.31 is a billable code used to indicate a diagnosis of deep phlebothrombosis in pregnancy, first trimester.

Key Diagnostic Point:

Deep phlebothrombosis (DVT) in pregnancy, particularly during the first trimester, is a serious condition characterized by the formation of a blood clot in the deep veins, most commonly in the legs. This condition poses significant risks to both the mother and fetus, including potential complications such as pulmonary embolism, which can be life-threatening. The incidence of DVT is increased during pregnancy due to physiological changes such as increased blood volume, hormonal changes that promote coagulation, and venous stasis caused by the growing uterus. Early diagnosis and management are crucial, often involving imaging studies like Doppler ultrasound and the use of anticoagulants to prevent clot progression and complications. Careful monitoring and follow-up are essential to ensure maternal and fetal safety, particularly in the context of anticoagulation therapy, which requires balancing the risks of thrombosis against the risks of bleeding. Coders must ensure accurate documentation of the condition, treatment plans, and any associated complications to facilitate appropriate coding and billing.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between DVT and superficial thrombophlebitis
  • Understanding the implications of anticoagulation therapy during pregnancy
  • Documenting the clinical rationale for imaging studies
  • Identifying associated risk factors such as obesity or previous DVT

Audit Risk Factors

  • Inadequate documentation of risk factors for DVT
  • Failure to document the treatment plan and follow-up care
  • Misclassification of DVT severity or type
  • Lack of clarity in the documentation of anticoagulation therapy

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include details of the diagnosis, treatment plan, and any imaging studies performed.

Common Clinical Scenarios

A pregnant patient presents with leg swelling and pain; Doppler ultrasound confirms DVT.

Billing Considerations

Consideration of anticoagulation risks and benefits, especially in the first trimester.

Maternal-Fetal Medicine

Documentation Requirements

Detailed documentation of maternal and fetal monitoring, especially in high-risk cases.

Common Clinical Scenarios

A patient with a history of DVT presents for management during pregnancy.

Billing Considerations

Focus on high-risk factors and the need for multidisciplinary care.

Coding Guidelines

Inclusion Criteria

Use O22.31 When
  • Coders should adhere to the official ICD
  • CM guidelines for obstetric coding, ensuring that the diagnosis is clearly documented and that any associated conditions are coded appropriately
  • Specific criteria for pregnancy
  • related conditions must be met

Exclusion Criteria

Do NOT use O22.31 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76937CPT Code

Ultrasound, Doppler, extremity, unilateral

Clinical Scenario

Used to confirm DVT diagnosis in a pregnant patient presenting with leg symptoms.

Documentation Requirements

Document the indication for the ultrasound and findings.

Specialty Considerations

Ensure that the ultrasound is performed by a qualified provider and interpreted correctly.

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, including DVT, which enhances the ability to track and manage these conditions effectively. The granularity of ICD-10 codes helps in better understanding the epidemiology of DVT in pregnancy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including DVT, which enhances the ability to track and manage these conditions effectively. The granularity of ICD-10 codes helps in better understanding the epidemiology of DVT in pregnancy.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including DVT, which enhances the ability to track and manage these conditions effectively. The granularity of ICD-10 codes helps in better understanding the epidemiology of DVT in pregnancy.

Resources

Clinical References

  • •
    ACOG Practice Bulletin on Thrombosis in Pregnancy

Coding & Billing References

  • •
    ACOG Practice Bulletin on Thrombosis in Pregnancy

Frequently Asked Questions

What are the common symptoms of DVT in pregnancy?

Common symptoms include unilateral leg swelling, pain, tenderness, and warmth in the affected leg. Some patients may also experience changes in skin color.