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v1.0.0
ICD-10 Guide
ICD-10 CodesO26.613

O26.613

Billable

Liver and biliary tract disorders in pregnancy, third trimester

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

Code Description

ICD-10 O26.613 is a billable code used to indicate a diagnosis of liver and biliary tract disorders in pregnancy, third trimester.

Key Diagnostic Point:

Liver and biliary tract disorders during the third trimester of pregnancy can present significant challenges for maternal and fetal health. Conditions such as intrahepatic cholestasis of pregnancy, acute fatty liver of pregnancy, and hepatitis can complicate the pregnancy, leading to increased risks for both the mother and the fetus. Symptoms may include jaundice, pruritus, abdominal pain, and elevated liver enzymes. Management often requires a multidisciplinary approach, including obstetricians, maternal-fetal medicine specialists, and hepatologists. Close monitoring of liver function tests and fetal well-being is essential. The timing of delivery may be influenced by the severity of the liver disorder, with early delivery considered in cases of severe cholestasis or acute fatty liver to prevent complications such as fetal distress or stillbirth. Proper documentation of the condition, its severity, and the management plan is crucial for accurate coding and reimbursement.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variety of liver and biliary tract disorders that can occur during pregnancy.
  • Need for detailed documentation of symptoms and management plans.
  • Potential for overlapping symptoms with other pregnancy complications.
  • Variability in treatment approaches based on severity and maternal-fetal considerations.

Audit Risk Factors

  • Inadequate documentation of liver function tests and their results.
  • Failure to document the rationale for delivery timing.
  • Lack of clarity on the severity of the liver disorder.
  • Insufficient detail on the multidisciplinary approach to care.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of maternal symptoms, liver function tests, and management strategies.

Common Clinical Scenarios

Management of a pregnant patient presenting with jaundice and elevated liver enzymes.

Billing Considerations

Consideration of fetal monitoring and potential early delivery based on maternal liver health.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including maternal history and current liver function.

Common Clinical Scenarios

Assessment of fetal well-being in a patient with intrahepatic cholestasis.

Billing Considerations

Focus on the implications of liver disorders on fetal outcomes and the need for specialized care.

Coding Guidelines

Inclusion Criteria

Use O26.613 When
  • Follow official ICD
  • CM guidelines for coding obstetric conditions, ensuring specificity in documenting the type of liver disorder and its impact on pregnancy

Exclusion Criteria

Do NOT use O26.613 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99203CPT Code

Office or other outpatient visit for the evaluation and management of a new patient

Clinical Scenario

Used for initial evaluation of a pregnant patient with liver dysfunction.

Documentation Requirements

Document history, physical examination, and any lab results.

Specialty Considerations

Obstetricians should ensure that all relevant symptoms and lab findings are included.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of liver disorders in pregnancy, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of liver disorders in pregnancy, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 liver disorders that can occur in pregnancy?

Common liver disorders in pregnancy include intrahepatic cholestasis of pregnancy, acute fatty liver of pregnancy, and hepatitis. Each condition has specific management protocols and implications for both maternal and fetal health.