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ICD-10 Guide
ICD-10 CodesO26.53

O26.53

Billable

Maternal hypotension syndrome, third trimester

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

Code Description

ICD-10 O26.53 is a billable code used to indicate a diagnosis of maternal hypotension syndrome, third trimester.

Key Diagnostic Point:

Maternal hypotension syndrome in the third trimester is characterized by a significant drop in blood pressure that can occur during pregnancy, particularly in the later stages. This condition can lead to inadequate blood flow to vital organs, including the placenta, which may compromise fetal well-being. It is often associated with conditions such as preeclampsia, gestational hypertension, or other cardiovascular issues. Symptoms may include dizziness, fainting, and fatigue, and it can be exacerbated by prolonged standing, dehydration, or certain medications. Management typically involves monitoring blood pressure, ensuring adequate hydration, and in some cases, adjusting medications. Close observation is crucial to prevent complications for both the mother and the fetus, particularly in high-risk pregnancies where maternal health is already compromised.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various types of hypotension and their causes.
  • Understanding the interplay between maternal conditions (renal, cardiac, respiratory) and hypotension.
  • Recognizing the implications of hypotension on fetal health and development.
  • Navigating the documentation requirements for high-risk pregnancies.

Audit Risk Factors

  • Inadequate documentation of maternal symptoms and vital signs.
  • Failure to link hypotension to specific underlying conditions.
  • Misclassification of hypotension severity.
  • Omission of relevant co-morbidities that may affect coding.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of blood pressure readings, symptoms, and any interventions taken.

Common Clinical Scenarios

A pregnant patient presenting with dizziness and low blood pressure during a routine check-up.

Billing Considerations

Coders must ensure that all relevant maternal health conditions are documented to support the diagnosis.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of maternal and fetal assessments, including ultrasound findings and fetal heart rate monitoring.

Common Clinical Scenarios

Management of a high-risk pregnancy with pre-existing cardiac conditions leading to hypotension.

Billing Considerations

High-risk scenarios require careful coding to reflect the complexity of care provided.

Coding Guidelines

Inclusion Criteria

Use O26.53 When
  • Coders should refer to the official ICD
  • CM guidelines for obstetric coding, ensuring that all relevant conditions are captured and that the codes are sequenced correctly based on the clinical scenario

Exclusion Criteria

Do NOT use O26.53 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, level 3

Clinical Scenario

Used for routine follow-up visits for pregnant patients with hypotension.

Documentation Requirements

Document blood pressure readings, symptoms, and any changes in treatment.

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, improving the accuracy of data collection and reimbursement processes. O26.53 provides a clear distinction for maternal hypotension in the third trimester, which was less defined in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of maternal conditions, improving the accuracy of data collection and reimbursement processes. O26.53 provides a clear distinction for maternal hypotension in the third trimester, which was less defined in ICD-9.

Reimbursement & Billing Impact

reimbursement processes. O26.53 provides a clear distinction for maternal hypotension in the third trimester, which was less defined in ICD-9.

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 are the common symptoms of maternal hypotension syndrome?

Common symptoms include dizziness, fainting, fatigue, and palpitations. It is important for healthcare providers to monitor these symptoms closely, especially in the third trimester.