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v1.0.0
ICD-10 Guide
ICD-10 CodesO25.1

O25.1

Billable

Malnutrition in pregnancy

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

Code Description

ICD-10 O25.1 is a billable code used to indicate a diagnosis of malnutrition in pregnancy.

Key Diagnostic Point:

Malnutrition in pregnancy refers to a state of nutritional deficiency or imbalance that can adversely affect maternal and fetal health. This condition can arise from inadequate dietary intake, poor absorption of nutrients, or increased nutritional needs during pregnancy. Malnutrition can manifest as undernutrition, where the mother does not consume enough calories or essential nutrients, or as overnutrition, leading to obesity and associated complications. Pregnant women with malnutrition may experience complications such as low birth weight, preterm birth, and developmental issues in the fetus. Eating disorders, such as anorexia nervosa or bulimia, can exacerbate malnutrition, necessitating comprehensive nutritional counseling and intervention. Healthcare providers must assess dietary habits, weight gain patterns, and overall health to identify malnutrition early and implement appropriate nutritional support and counseling to ensure optimal outcomes for both mother and child.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes (e.g., eating disorders, socioeconomic factors)
  • Need for comprehensive documentation of dietary assessments
  • Potential overlap with other obstetric codes (e.g., O25.0, O25.2)
  • Variability in clinical presentation and severity

Audit Risk Factors

  • Inadequate documentation of nutritional assessments
  • Failure to document the impact of malnutrition on pregnancy outcomes
  • Misclassification of malnutrition severity
  • Lack of interdisciplinary notes from dietitians or nutritionists

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed dietary history, weight gain tracking, and nutritional counseling notes.

Common Clinical Scenarios

Pregnant women presenting with low BMI, history of eating disorders, or inadequate weight gain.

Billing Considerations

Ensure accurate coding of malnutrition severity and related complications.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive assessments of maternal and fetal health, including nutritional status and growth parameters.

Common Clinical Scenarios

High-risk pregnancies with documented malnutrition or eating disorders requiring specialized care.

Billing Considerations

Focus on the impact of malnutrition on fetal development and maternal health.

Coding Guidelines

Inclusion Criteria

Use O25.1 When
  • Follow official ICD
  • CM guidelines for coding malnutrition in pregnancy, ensuring accurate documentation of the condition's severity and any associated complications
  • Use additional codes for related conditions such as eating disorders when applicable

Exclusion Criteria

Do NOT use O25.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

97802CPT Code

Medical nutrition therapy, individual, face-to-face

Clinical Scenario

Used for patients requiring nutritional counseling due to malnutrition in pregnancy.

Documentation Requirements

Document the patient's nutritional status, goals, and progress.

Specialty Considerations

Ensure collaboration with dietitians for comprehensive care.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of malnutrition in pregnancy, improving the ability to capture the complexity of maternal nutritional status and its impact on pregnancy outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of malnutrition in pregnancy, improving the ability to capture the complexity of maternal nutritional status and its impact on pregnancy outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of malnutrition in pregnancy, improving the ability to capture the complexity of maternal nutritional status and its impact on pregnancy outcomes.

Resources

Clinical References

  • •
    Nutrition in Pregnancy: A Guide for Health Professionals

Coding & Billing References

  • •
    Nutrition in Pregnancy: A Guide for Health Professionals

Frequently Asked Questions

What are the signs of malnutrition in pregnancy?

Signs of malnutrition in pregnancy can include significant weight loss, fatigue, weakness, and poor fetal growth. Healthcare providers should assess dietary intake and monitor weight gain to identify malnutrition early.