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ICD-10 Guide
ICD-10 CodesO25.11

O25.11

Billable

Malnutrition in pregnancy, first trimester

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

Code Description

ICD-10 O25.11 is a billable code used to indicate a diagnosis of malnutrition in pregnancy, first trimester.

Key Diagnostic Point:

Malnutrition in pregnancy during the first trimester can significantly impact both maternal and fetal health. This condition may arise from inadequate dietary intake, eating disorders, or socioeconomic factors that limit access to nutritious food. Malnutrition can lead to complications such as low birth weight, preterm birth, and developmental issues in the fetus. It is crucial for healthcare providers to assess nutritional status early in pregnancy, particularly in high-risk populations. Nutritional counseling should be provided to address dietary deficiencies and promote healthy eating habits. This may include education on caloric intake, macronutrient balance, and the importance of vitamins and minerals essential for fetal development. Regular monitoring and follow-up are necessary to ensure that the mother receives adequate nutrition throughout her pregnancy, especially during the critical first trimester when fetal organogenesis occurs.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes for malnutrition (e.g., eating disorders, socioeconomic status)
  • Need for comprehensive documentation of dietary habits and nutritional assessments
  • Potential overlap with other codes related to pregnancy complications
  • Variability in clinical presentation and severity of malnutrition

Audit Risk Factors

  • Inadequate documentation of nutritional assessments
  • Failure to specify the type of malnutrition (e.g., protein-energy malnutrition)
  • Lack of evidence for nutritional counseling provided
  • Misclassification of malnutrition severity

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of maternal dietary intake, weight changes, and any referrals for nutritional counseling.

Common Clinical Scenarios

Pregnant patients presenting with weight loss, food aversions, or a history of eating disorders.

Billing Considerations

Consideration of cultural dietary practices and their impact on nutritional status.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including pre-existing conditions and psychosocial factors affecting nutrition.

Common Clinical Scenarios

Management of pregnancies complicated by severe malnutrition or eating disorders requiring specialized care.

Billing Considerations

Close monitoring of fetal growth and development, with potential referrals to dietitians.

Coding Guidelines

Inclusion Criteria

Use O25.11 When
  • Follow the official ICD
  • CM coding guidelines for obstetric conditions, ensuring accurate documentation of the patient's nutritional status and any related complications
  • Specific criteria for malnutrition must be met, including clinical assessment and dietary history

Exclusion Criteria

Do NOT use O25.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

97802CPT Code

Medical nutrition therapy, individual, face-to-face

Clinical Scenario

Used when a patient is referred for nutritional counseling due to malnutrition in pregnancy.

Documentation Requirements

Documentation of the patient's nutritional status and goals for therapy.

Specialty Considerations

Obstetricians should collaborate 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, enabling better tracking of maternal and fetal outcomes and improving the quality of care provided.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of malnutrition in pregnancy, enabling better tracking of maternal and fetal outcomes and improving the quality of care provided.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of malnutrition in pregnancy, enabling better tracking of maternal and fetal outcomes and improving the quality of care provided.

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 common causes of malnutrition in pregnancy?

Common causes include inadequate dietary intake, eating disorders, socioeconomic factors, and medical conditions that affect nutrient absorption. Early identification and intervention are crucial for maternal and fetal health.