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ICD-10 Guide
ICD-10 CodesO24.119

O24.119

Billable

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

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

Code Description

ICD-10 O24.119 is a billable code used to indicate a diagnosis of pre-existing type 2 diabetes mellitus, in pregnancy, unspecified trimester.

Key Diagnostic Point:

Pre-existing type 2 diabetes mellitus in pregnancy poses significant risks to both the mother and fetus. This condition requires careful management throughout the pregnancy to prevent complications such as fetal 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, often involving ultrasound assessments and non-stress tests. The management plan should be individualized, taking into account the mother's pre-pregnancy health status, the severity of diabetes, and any comorbid conditions. Coordination among healthcare providers, including obstetricians, endocrinologists, and dietitians, is vital to ensure comprehensive care. Education on dietary modifications, blood glucose monitoring, and recognizing signs of complications is also a key component of managing diabetes in pregnancy.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variability in insulin management and dosage adjustments during pregnancy.
  • Need for continuous fetal monitoring and assessment of fetal growth.
  • Potential for multiple comorbidities affecting pregnancy outcomes.
  • Complexity in documenting changes in maternal health status and treatment plans.

Audit Risk Factors

  • Inadequate documentation of blood glucose levels and insulin adjustments.
  • Failure to document the trimester of pregnancy when complications arise.
  • Lack of interdisciplinary communication notes in the medical record.
  • Insufficient detail on fetal monitoring results and interventions.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of maternal health, including pre-existing conditions, treatment plans, and monitoring results.

Common Clinical Scenarios

Management of a pregnant patient with type 2 diabetes requiring insulin therapy and regular fetal assessments.

Billing Considerations

Ensure accurate documentation of any changes in maternal or fetal health status, and the rationale for treatment adjustments.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including maternal diabetes management and fetal monitoring protocols.

Common Clinical Scenarios

High-risk pregnancies involving pre-existing diabetes with potential complications such as preeclampsia or fetal growth restriction.

Billing Considerations

Focus on detailed assessments of fetal well-being and maternal health, including any interventions taken.

Coding Guidelines

Inclusion Criteria

Use O24.119 When
  • Follow official ICD
  • 10 guidelines for coding diabetes in pregnancy, ensuring accurate documentation of the condition's impact on maternal and fetal health
  • Specific criteria for trimester designation must be adhered to, even when unspecified

Exclusion Criteria

Do NOT use O24.119 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for routine follow-up visits for a pregnant patient with type 2 diabetes.

Documentation Requirements

Document the patient's diabetes management plan, including blood glucose levels and any changes in treatment.

Specialty Considerations

Ensure that the visit reflects the complexity of managing a chronic condition during 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 ability to track and manage maternal and fetal health outcomes. It emphasizes the importance of documenting the trimester and the type of diabetes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of diabetes in pregnancy, improving the ability to track and manage maternal and fetal health outcomes. It emphasizes the importance of documenting the trimester and the type of diabetes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of diabetes in pregnancy, improving the ability to track and manage maternal and fetal health outcomes. It emphasizes the importance of documenting the trimester and the type of diabetes.

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 and typically resolves after delivery. Accurate coding is essential to reflect the patient's condition.