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ICD-10 Guide
ICD-10 CodesO24.414

O24.414

Billable

Gestational diabetes mellitus in pregnancy, insulin controlled

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

Code Description

ICD-10 O24.414 is a billable code used to indicate a diagnosis of gestational diabetes mellitus in pregnancy, insulin controlled.

Key Diagnostic Point:

Gestational diabetes mellitus (GDM) is a form of diabetes that develops during pregnancy and typically resolves after childbirth. It occurs when the body cannot produce enough insulin to meet the increased demands during pregnancy, leading to elevated blood glucose levels. Insulin-controlled gestational diabetes indicates that the condition is being managed with insulin therapy, which is often necessary when dietary modifications and exercise alone are insufficient to maintain normal blood glucose levels. Proper management is crucial to minimize risks to both the mother and fetus, including macrosomia, preterm birth, and the development of type 2 diabetes later in life. Regular fetal monitoring is essential to assess the well-being of the fetus, as well as to adjust insulin dosages based on maternal blood glucose readings. Healthcare providers must ensure that patients receive education on self-monitoring of blood glucose, dietary management, and the importance of adhering to treatment plans to achieve optimal outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for accurate blood glucose monitoring documentation
  • Variability in insulin management protocols
  • Potential for co-existing conditions (e.g., obesity, hypertension)
  • Documentation of fetal monitoring and outcomes

Audit Risk Factors

  • Inadequate documentation of insulin therapy
  • Failure to document blood glucose levels
  • Lack of evidence for fetal monitoring
  • Misclassification of gestational diabetes type

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of blood glucose levels, insulin dosages, and dietary modifications are essential for accurate coding.

Common Clinical Scenarios

Patients diagnosed with GDM requiring insulin therapy, routine prenatal visits with glucose monitoring, and delivery planning.

Billing Considerations

Consideration of potential complications such as preeclampsia or fetal macrosomia that may arise from poorly managed GDM.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including maternal obesity, previous GDM history, and current management strategies.

Common Clinical Scenarios

Management of GDM in patients with additional risk factors, close monitoring of fetal growth, and planning for delivery.

Billing Considerations

High-risk patients may require more frequent monitoring and adjustments to insulin therapy based on fetal assessments.

Coding Guidelines

Inclusion Criteria

Use O24.414 When
  • Coders should refer to the official ICD
  • CM guidelines for obstetric coding, ensuring that the diagnosis is documented accurately and that any associated conditions are coded appropriately
  • Specific criteria for gestational diabetes must be met, including the timing of diagnosis and management strategies

Exclusion Criteria

Do NOT use O24.414 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, level 3

Clinical Scenario

Used during routine follow-up visits for GDM management.

Documentation Requirements

Documentation of blood glucose levels, insulin management, and patient education.

Specialty Considerations

Obstetricians should ensure comprehensive notes on the patient's progress and any adjustments to treatment.

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 ability to track and manage this condition effectively. It has also enhanced the granularity of data for research and quality improvement initiatives.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of gestational diabetes, improving the ability to track and manage this condition effectively. It has also enhanced the granularity of data for research and quality improvement initiatives.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of gestational diabetes, improving the ability to track and manage this condition effectively. It has also enhanced the granularity of data for research and quality improvement initiatives.

Resources

Clinical References

  • •
    American Diabetes Association - Gestational Diabetes

Coding & Billing References

  • •
    American Diabetes Association - Gestational Diabetes

Frequently Asked Questions

What is the difference between O24.414 and O24.413?

O24.414 is used when gestational diabetes is managed with insulin, while O24.413 is for cases controlled by diet alone. Accurate coding depends on the management strategy employed.