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ICD-10 Guide
ICD-10 CodesO26.50

O26.50

Billable

Maternal hypotension syndrome, unspecified trimester

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

Code Description

ICD-10 O26.50 is a billable code used to indicate a diagnosis of maternal hypotension syndrome, unspecified trimester.

Key Diagnostic Point:

Maternal hypotension syndrome refers to a condition characterized by abnormally low blood pressure during pregnancy, which can lead to inadequate blood flow to vital organs, including the placenta. This syndrome can manifest in any trimester and may be associated with various complications, particularly in women with pre-existing conditions such as renal, cardiac, or respiratory issues. The condition can result from physiological changes during pregnancy, such as increased blood volume and hormonal fluctuations, or may be exacerbated by underlying health problems. Symptoms may include dizziness, fainting, and fatigue, which can impact maternal and fetal well-being. Management often involves monitoring blood pressure, hydration, and, in some cases, medication adjustments. It is crucial for healthcare providers to document the severity, duration, and any associated symptoms to ensure appropriate coding and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in symptoms and severity of hypotension
  • Differentiation from other hypertensive disorders in pregnancy
  • Potential overlap with other maternal conditions (e.g., cardiac issues)
  • Need for detailed documentation of maternal history and current health status

Audit Risk Factors

  • Inadequate documentation of maternal symptoms
  • Failure to specify the trimester of occurrence
  • Misclassification of hypotension as a hypertensive disorder
  • Lack of clarity regarding underlying health conditions

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed maternal history, including any pre-existing conditions, current medications, and symptoms experienced.

Common Clinical Scenarios

A pregnant patient presenting with dizziness and fainting spells, requiring evaluation for hypotension.

Billing Considerations

Ensure accurate documentation of blood pressure readings and any interventions taken.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive assessment of maternal and fetal health, including ultrasound findings and fetal monitoring.

Common Clinical Scenarios

Management of a high-risk pregnancy with maternal hypotension and underlying cardiac disease.

Billing Considerations

Focus on the impact of maternal hypotension on fetal well-being and the need for close monitoring.

Coding Guidelines

Inclusion Criteria

Use O26.50 When
  • Follow the official ICD
  • CM coding guidelines for obstetric conditions, ensuring that the code reflects the specific trimester and any associated complications
  • Documentation must support the diagnosis and treatment provided

Exclusion Criteria

Do NOT use O26.50 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits to monitor maternal hypotension and associated symptoms.

Documentation Requirements

Document the patient's symptoms, blood pressure readings, and any interventions.

Specialty Considerations

Ensure that the visit is clearly linked to the management of hypotension.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of maternal conditions, including hypotension, which aids in better tracking and management of these conditions in pregnancy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of maternal conditions, including hypotension, which aids in better tracking and management of these conditions in pregnancy.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of maternal conditions, including hypotension, which aids in better tracking and management of these conditions in pregnancy.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What are the common symptoms of maternal hypotension syndrome?

Common symptoms include dizziness, fainting, fatigue, and palpitations. It is essential to monitor these symptoms closely, especially in patients with underlying health conditions.