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ICD-10 Guide
ICD-10 CodesO22.91

O22.91

Billable

Venous complication in pregnancy, unspecified, first trimester

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

Code Description

ICD-10 O22.91 is a billable code used to indicate a diagnosis of venous complication in pregnancy, unspecified, first trimester.

Key Diagnostic Point:

Venous complications during pregnancy can manifest in various forms, including deep vein thrombosis (DVT) and superficial venous thrombosis. These conditions are particularly concerning during the first trimester due to the physiological changes that occur in a woman's body, such as increased blood volume and changes in coagulation factors. The risk of venous complications is heightened by factors such as obesity, a history of venous thromboembolism, and prolonged immobility. Symptoms may include swelling, pain, and tenderness in the affected limb, which can lead to significant morbidity if not addressed promptly. The management of venous complications often involves anticoagulation therapy, which must be carefully monitored to balance the risks of thrombosis against potential bleeding complications. Accurate coding of these conditions is crucial for appropriate treatment and reimbursement, as well as for tracking maternal and fetal outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation of venous complications
  • Need for detailed patient history to determine risk factors
  • Differentiation between types of venous complications
  • Potential for overlapping symptoms with other conditions

Audit Risk Factors

  • Inadequate documentation of symptoms and treatment
  • Failure to specify the trimester of pregnancy
  • Misclassification of the type of venous complication
  • Lack of follow-up documentation on anticoagulation therapy

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of symptoms, risk factors, and treatment plans is essential. Providers should note any history of venous thromboembolism and current anticoagulation therapy.

Common Clinical Scenarios

A pregnant patient presents with unilateral leg swelling and pain, prompting evaluation for DVT. Another scenario may involve a patient with a history of thrombosis requiring anticoagulation management during pregnancy.

Billing Considerations

Coders must ensure that the documentation clearly indicates the trimester and the specific venous complication to avoid coding errors.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancies necessitate comprehensive documentation, including maternal history, current medications, and monitoring of both maternal and fetal health.

Common Clinical Scenarios

Management of a pregnant patient with a history of DVT who requires close monitoring and anticoagulation therapy throughout the first trimester.

Billing Considerations

High-risk coding requires attention to detail in documenting the patient's condition and treatment plan, as well as any consultations with specialists.

Coding Guidelines

Inclusion Criteria

Use O22.91 When
  • Follow the ICD
  • CM guidelines for obstetric coding, ensuring that the trimester is specified and that the documentation supports the diagnosis
  • Use additional codes for any associated conditions or complications

Exclusion Criteria

Do NOT use O22.91 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits for patients with venous complications during pregnancy.

Documentation Requirements

Document the patient's history, examination findings, and treatment plan.

Specialty Considerations

Ensure that the visit is clearly related to the management of the venous complication.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of venous complications, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of documenting the trimester and specific complications.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of venous complications, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of documenting the trimester and specific complications.

Reimbursement & Billing Impact

reimbursement processes. It emphasizes the importance of documenting the trimester and specific complications.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What are the common symptoms of venous complications in pregnancy?

Common symptoms include swelling, pain, and tenderness in the legs, particularly if there is a history of thrombosis. Patients may also experience warmth and redness in the affected area.