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ICD-10 Guide
ICD-10 CodesO24.41

O24.41

Billable

Gestational diabetes mellitus in pregnancy

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

Code Description

ICD-10 O24.41 is a billable code used to indicate a diagnosis of gestational diabetes mellitus in pregnancy.

Key Diagnostic Point:

Gestational diabetes mellitus (GDM) is a form of diabetes that develops during pregnancy and typically resolves after childbirth. It is characterized by glucose intolerance that is first recognized during pregnancy. The condition can lead to various complications for both the mother and the fetus, including increased risk of cesarean delivery, macrosomia (large baby), and neonatal hypoglycemia. Management of GDM often involves dietary modifications, blood glucose monitoring, and in some cases, insulin therapy. Insulin is used when dietary changes alone are insufficient to maintain normal blood glucose levels. Regular fetal monitoring is crucial to assess fetal growth and well-being, as well as to identify any potential complications early. The diagnosis of GDM is typically made through screening tests, such as the oral glucose tolerance test (OGTT), performed between 24 and 28 weeks of gestation. Proper management and monitoring can significantly reduce the risks associated with GDM, ensuring better outcomes for both mother and child.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in diagnostic criteria for GDM based on different guidelines.
  • Need for accurate documentation of blood glucose levels and management strategies.
  • Potential for co-morbid conditions that may complicate coding.
  • Variations in treatment protocols and monitoring requirements.

Audit Risk Factors

  • Inadequate documentation of glucose monitoring and treatment plans.
  • Failure to document the onset of diabetes during pregnancy.
  • Misclassification of GDM as pre-existing diabetes.
  • Lack of follow-up documentation post-delivery.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include glucose testing results, dietary management plans, and any insulin therapy prescribed.

Common Clinical Scenarios

Routine screening for GDM, management of GDM with diet alone, and management requiring insulin therapy.

Billing Considerations

Accurate coding requires clear documentation of the timing of diagnosis and any complications arising from GDM.

Maternal-Fetal Medicine

Documentation Requirements

Detailed documentation of high-risk factors, fetal monitoring results, and any interventions performed.

Common Clinical Scenarios

Management of GDM in patients with additional risk factors such as obesity or previous GDM.

Billing Considerations

High-risk pregnancies may require more frequent monitoring and intervention, necessitating thorough documentation.

Coding Guidelines

Inclusion Criteria

Use O24.41 When
  • 10 coding guidelines for O24
  • 41 require documentation of the diagnosis of gestational diabetes, the management plan, and any complications
  • It is essential to follow the guidelines set forth by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists for accurate coding

Exclusion Criteria

Do NOT use O24.41 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 to monitor GDM management.

Documentation Requirements

Documentation of glucose levels, dietary changes, and any medications prescribed.

Specialty Considerations

Obstetricians should ensure that all aspects of GDM management are documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of gestational diabetes, improving the accuracy of data collection and reimbursement processes. It has also enhanced the ability to track outcomes and complications associated with GDM.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of gestational diabetes, improving the accuracy of data collection and reimbursement processes. It has also enhanced the ability to track outcomes and complications associated with GDM.

Reimbursement & Billing Impact

reimbursement processes. It has also enhanced the ability to track outcomes and complications associated with GDM.

Resources

Clinical References

  • •
    Gestational Diabetes: A Guide for Healthcare Providers

Coding & Billing References

  • •
    Gestational Diabetes: A Guide for Healthcare Providers

Frequently Asked Questions

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

Gestational diabetes occurs during pregnancy and typically resolves after childbirth, while pre-existing diabetes is a chronic condition that exists before pregnancy. Accurate coding requires distinguishing between the two based on the patient's medical history and diagnostic testing.