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ICD-10 Guide
ICD-10 CodesO24.01

O24.01

Billable

Pre-existing type 1 diabetes mellitus, in pregnancy

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

Code Description

ICD-10 O24.01 is a billable code used to indicate a diagnosis of pre-existing type 1 diabetes mellitus, in pregnancy.

Key Diagnostic Point:

Pre-existing type 1 diabetes mellitus in pregnancy presents unique challenges for both the mother and the fetus. Women with type 1 diabetes have a higher risk of complications during pregnancy, including preeclampsia, fetal growth abnormalities, and congenital malformations. Effective management of blood glucose levels is crucial to minimize these risks. Insulin therapy is typically required to maintain glycemic control, and frequent monitoring of blood glucose levels is essential. Additionally, fetal monitoring through ultrasound and non-stress tests is often employed to assess fetal well-being and growth. Close collaboration among obstetricians, endocrinologists, and maternal-fetal medicine specialists is vital to ensure optimal outcomes for both mother and child. Education on dietary management, exercise, and the importance of regular prenatal visits is also critical in managing this condition during pregnancy.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Need for precise documentation of diabetes management and insulin therapy.
  • Variability in maternal blood glucose levels and their impact on fetal health.
  • Increased risk of complications requiring additional monitoring and interventions.
  • Coordination of care among multiple specialties (obstetrics, endocrinology, maternal-fetal medicine).

Audit Risk Factors

  • Inadequate documentation of blood glucose monitoring and insulin management.
  • Failure to document complications related to diabetes.
  • Incorrect coding of diabetes type or pregnancy complications.
  • Lack of clear linkage between diagnosis and treatment provided.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of prenatal visits, including blood glucose levels, insulin dosages, and any complications.

Common Clinical Scenarios

Management of insulin therapy adjustments, monitoring for preeclampsia, and fetal growth assessments.

Billing Considerations

Ensure accurate coding of any complications arising from diabetes, such as hypertensive disorders or fetal anomalies.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk assessments, including ultrasound findings and fetal monitoring results.

Common Clinical Scenarios

Management of high-risk pregnancies with pre-existing diabetes, including potential interventions.

Billing Considerations

Focus on the multidisciplinary approach to care and the need for detailed documentation of all consultations and interventions.

Coding Guidelines

Inclusion Criteria

Use O24.01 When
  • Follow the ICD
  • CM guidelines for coding diabetes in pregnancy, ensuring that the type of diabetes is accurately documented and that any complications are coded appropriately
  • Use additional codes for complications as necessary

Exclusion Criteria

Do NOT use O24.01 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99203CPT Code

Office or other outpatient visit for the evaluation and management of a new patient

Clinical Scenario

Used for initial prenatal visits for patients with pre-existing diabetes.

Documentation Requirements

Document medical history, physical examination, and management plan.

Specialty Considerations

Ensure that the visit includes a comprehensive assessment of diabetes management.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of diabetes in pregnancy, improving the ability to capture the complexity of managing pre-existing conditions and their associated complications.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of diabetes in pregnancy, improving the ability to capture the complexity of managing pre-existing conditions and their associated complications.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of diabetes in pregnancy, improving the ability to capture the complexity of managing pre-existing conditions and their associated complications.

Resources

Clinical References

  • •
    American Diabetes Association - Diabetes and Pregnancy

Coding & Billing References

  • •
    American Diabetes Association - Diabetes and Pregnancy

Frequently Asked Questions

What is the difference between pre-existing diabetes and gestational diabetes?

Pre-existing diabetes refers to diabetes that was diagnosed before pregnancy, while gestational diabetes develops during pregnancy. Accurate coding is essential to reflect the patient's condition and management needs.