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ICD-10 Guide
ICD-10 CodesO24.113

O24.113

Billable

Pre-existing type 2 diabetes mellitus, in pregnancy, third trimester

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

Code Description

ICD-10 O24.113 is a billable code used to indicate a diagnosis of pre-existing type 2 diabetes mellitus, in pregnancy, third trimester.

Key Diagnostic Point:

Pre-existing type 2 diabetes mellitus in pregnancy poses significant risks to both the mother and fetus, particularly during the third trimester. This condition requires careful management to prevent complications such as macrosomia, preeclampsia, and neonatal hypoglycemia. Women with pre-existing type 2 diabetes may require insulin therapy to maintain optimal glycemic control, which is crucial for reducing adverse pregnancy outcomes. Regular fetal monitoring is essential to assess fetal growth and well-being, including ultrasound evaluations and non-stress tests. The management plan should include dietary modifications, blood glucose monitoring, and potential adjustments in medication dosages. Coordination among healthcare providers, including obstetricians and endocrinologists, is vital to ensure comprehensive care throughout the pregnancy.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Need for precise documentation of diabetes management and control
  • Variability in treatment protocols based on individual patient needs
  • Potential for multiple co-morbidities affecting pregnancy outcomes
  • Involvement of multidisciplinary teams for optimal care

Audit Risk Factors

  • Inadequate documentation of blood glucose levels and management plans
  • Failure to document the impact of diabetes on pregnancy outcomes
  • Lack of coordination notes between specialists
  • Missing documentation of fetal monitoring results

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of maternal health, diabetes management, and fetal assessments are essential.

Common Clinical Scenarios

Management of labor in diabetic patients, monitoring for complications such as preeclampsia.

Billing Considerations

Ensure accurate coding of any complications arising from diabetes, including the need for insulin therapy.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including maternal and fetal assessments.

Common Clinical Scenarios

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

Billing Considerations

Focus on the implications of diabetes on fetal development and the need for specialized monitoring.

Coding Guidelines

Inclusion Criteria

Use O24.113 When
  • Follow official ICD
  • 10 guidelines for coding diabetes in pregnancy, ensuring that the code reflects the trimester and the presence of any complications
  • Documentation must support the diagnosis and treatment plan

Exclusion Criteria

Do NOT use O24.113 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99203CPT Code

Office visit for established patient, moderate complexity

Clinical Scenario

Used for routine follow-up visits for diabetic management during pregnancy.

Documentation Requirements

Document patient history, examination findings, and management plan.

Specialty Considerations

Ensure that the visit reflects the complexity of managing diabetes in pregnancy.

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 accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of diabetes in pregnancy, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    American Diabetes Association - Diabetes and Pregnancy

Coding & Billing References

  • •
    American Diabetes Association - Diabetes and Pregnancy

Frequently Asked Questions

What is the significance of coding O24.113 correctly?

Correct coding of O24.113 is crucial for ensuring appropriate reimbursement and for tracking maternal and fetal outcomes in pregnancies complicated by diabetes. Accurate coding reflects the complexity of care required and helps in the management of resources for high-risk pregnancies.