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ICD-10 Guide
ICD-10 CodesO26.10

O26.10

Billable

Low weight gain in pregnancy, unspecified trimester

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

Code Description

ICD-10 O26.10 is a billable code used to indicate a diagnosis of low weight gain in pregnancy, unspecified trimester.

Key Diagnostic Point:

Low weight gain during pregnancy can be a significant concern for maternal and fetal health. It is defined as insufficient weight gain according to established guidelines, which can vary based on pre-pregnancy body mass index (BMI). Insufficient weight gain may lead to complications such as intrauterine growth restriction (IUGR), preterm birth, and low birth weight. Factors contributing to low weight gain can include maternal health conditions such as renal, cardiac, or respiratory issues, which may affect nutritional intake or absorption. For instance, renal conditions may necessitate dietary restrictions that limit caloric intake, while cardiac conditions may lead to fatigue and decreased appetite. Respiratory issues can also impact a mother's ability to consume adequate nutrition. It is crucial for healthcare providers to monitor weight gain closely and address any underlying health issues to ensure optimal outcomes for both mother and child.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in weight gain recommendations based on pre-pregnancy BMI.
  • Need for comprehensive assessment of maternal health conditions.
  • Potential overlap with other obstetric codes related to weight gain.
  • Documentation requirements for underlying health conditions.

Audit Risk Factors

  • Inadequate documentation of maternal health conditions.
  • Failure to specify the trimester of pregnancy.
  • Misinterpretation of weight gain guidelines.
  • Lack of follow-up on weight gain assessments.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of weight gain, maternal health assessments, and dietary recommendations.

Common Clinical Scenarios

Patients with low weight gain due to nausea and vomiting, dietary restrictions, or chronic health conditions.

Billing Considerations

Consideration of the patient's pre-pregnancy BMI and any comorbidities that may affect weight gain.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including renal, cardiac, and respiratory conditions.

Common Clinical Scenarios

Management of pregnancies complicated by maternal health issues that impact nutrition and weight gain.

Billing Considerations

Close monitoring of fetal growth and development in relation to maternal weight gain.

Coding Guidelines

Inclusion Criteria

Use O26.10 When
  • 10 coding guidelines emphasize the importance of specifying the trimester when applicable and documenting any underlying health conditions that may contribute to low weight gain
  • Coders should ensure that all relevant clinical information is captured to support the diagnosis

Exclusion Criteria

Do NOT use O26.10 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59400CPT Code

Obstetrical care, including antepartum care, delivery, and postpartum care

Clinical Scenario

Used for comprehensive obstetric care in patients with low weight gain.

Documentation Requirements

Complete records of prenatal visits, weight assessments, and any interventions.

Specialty Considerations

Obstetricians should document any complications related to low weight gain.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like low weight gain in pregnancy, enabling better tracking of maternal and fetal health outcomes. This specificity aids in research and quality improvement initiatives.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like low weight gain in pregnancy, enabling better tracking of maternal and fetal health outcomes. This specificity aids in research and quality improvement initiatives.

Reimbursement & Billing Impact

reimbursement and quality care metrics.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What should be documented to support the use of code O26.10?

Documentation should include the patient's weight gain trajectory, any underlying health conditions affecting weight gain, and the trimester of pregnancy. Regular weight assessments and dietary recommendations should also be recorded.