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ICD-10 Guide
ICD-10 CodesO24.91

O24.91

Billable

Unspecified diabetes mellitus in pregnancy

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

Code Description

ICD-10 O24.91 is a billable code used to indicate a diagnosis of unspecified diabetes mellitus in pregnancy.

Key Diagnostic Point:

Unspecified diabetes mellitus in pregnancy refers to a condition where a pregnant woman has diabetes that is not clearly defined as either gestational diabetes or pre-existing diabetes. This condition can lead to various complications for both the mother and the fetus, including increased risk of preeclampsia, cesarean delivery, and macrosomia (large for gestational age). Management typically involves monitoring blood glucose levels, dietary modifications, and possibly insulin therapy. Fetal monitoring is crucial to assess fetal well-being and growth, as uncontrolled diabetes can lead to adverse outcomes such as fetal distress or stillbirth. The diagnosis requires careful documentation of the patient's medical history, including any previous episodes of diabetes, current management strategies, and any complications arising during the pregnancy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of diabetes (gestational vs. pre-existing)
  • Need for detailed documentation of blood glucose management
  • Monitoring requirements for fetal health
  • Potential for multiple comorbidities affecting pregnancy

Audit Risk Factors

  • Inadequate documentation of diabetes management
  • Failure to specify type of diabetes
  • Lack of fetal monitoring records
  • Inconsistent coding of related complications

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include detailed patient history, current management strategies, and any complications observed during pregnancy.

Common Clinical Scenarios

A patient with a history of diabetes presents for prenatal care; management of blood glucose levels during pregnancy.

Billing Considerations

Accurate coding requires clear documentation of the patient's diabetes status and any interventions undertaken.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancy documentation must include comprehensive assessments of both maternal and fetal health, including ultrasound findings and glucose monitoring.

Common Clinical Scenarios

Management of a pregnant patient with poorly controlled diabetes requiring insulin therapy and close fetal monitoring.

Billing Considerations

Special attention to the potential for fetal complications and the need for multidisciplinary care.

Coding Guidelines

Inclusion Criteria

Use O24.91 When
  • 10 coding guidelines specify that diabetes in pregnancy must be documented with the appropriate code based on the type and management of diabetes
  • Accurate coding is essential for reimbursement and quality of care

Exclusion Criteria

Do NOT use O24.91 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99203CPT Code

Office visit for new patient, moderate complexity

Clinical Scenario

Used for initial prenatal visits where diabetes management is discussed.

Documentation Requirements

Document patient's history, current management, and any referrals.

Specialty Considerations

Obstetricians should ensure comprehensive assessments are included.

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 diagnoses and treatment plans.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of diabetes in pregnancy, improving the accuracy of diagnoses and treatment plans.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of diabetes in pregnancy, improving the accuracy of diagnoses and treatment plans.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What is the difference between unspecified diabetes and gestational diabetes?

Unspecified diabetes refers to diabetes in pregnancy that is not clearly defined, while gestational diabetes is specifically diagnosed during pregnancy and typically resolves after delivery. Accurate coding is essential for appropriate management and care.