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ICD-10 Guide
ICD-10 CodesO25.13

O25.13

Billable

Malnutrition in pregnancy, third trimester

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

Code Description

ICD-10 O25.13 is a billable code used to indicate a diagnosis of malnutrition in pregnancy, third trimester.

Key Diagnostic Point:

Malnutrition in pregnancy during the third trimester is a significant concern that can adversely affect both maternal and fetal health. This condition may arise from inadequate dietary intake, eating disorders, or socioeconomic factors that limit access to nutritious food. In the third trimester, the fetus undergoes rapid growth and development, making maternal nutrition critical. Malnutrition can lead to complications such as low birth weight, preterm birth, and developmental delays. Clinicians must assess dietary habits, weight gain patterns, and overall health to identify malnutrition. Nutritional counseling is essential to address deficiencies and promote healthy eating habits. This may involve collaboration with dietitians to create tailored meal plans that meet the increased caloric and nutritional needs of the mother and fetus. Regular monitoring and follow-up are crucial to ensure that both mother and baby are receiving adequate nutrition during this vital stage of pregnancy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of malnutrition (e.g., protein-energy malnutrition vs. micronutrient deficiencies)
  • Identifying underlying causes such as eating disorders or socioeconomic factors
  • Documenting nutritional counseling and interventions accurately
  • Understanding the implications of malnutrition on fetal development and maternal health

Audit Risk Factors

  • Inadequate documentation of nutritional assessments and counseling
  • Failure to specify the type of malnutrition
  • Lack of follow-up documentation on maternal and fetal health outcomes
  • Misclassification of malnutrition severity

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of dietary intake, weight gain, and nutritional counseling provided to the patient.

Common Clinical Scenarios

Patients presenting with low weight gain, dietary restrictions, or diagnosed eating disorders during pregnancy.

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 their impact on nutrition.

Common Clinical Scenarios

Management of high-risk pregnancies where malnutrition is a concern due to multiple gestations or chronic illnesses.

Billing Considerations

Close monitoring of fetal growth and development in relation to maternal nutritional status.

Coding Guidelines

Inclusion Criteria

Use O25.13 When
  • Follow the official ICD
  • CM coding guidelines for obstetric conditions, ensuring that all relevant documentation supports the diagnosis of malnutrition in pregnancy
  • Specific criteria for malnutrition must be met, including clinical assessments and dietary evaluations

Exclusion Criteria

Do NOT use O25.13 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 assessment and counseling provided.

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, improving the ability to capture the nuances of maternal health and nutritional needs.

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 nuances of maternal health and nutritional needs.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of malnutrition in pregnancy, improving the ability to capture the nuances of maternal health and nutritional needs.

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 may include inadequate weight gain, fatigue, weakness, and specific nutrient deficiencies. Regular assessments and monitoring are essential to identify and address these issues.