Intrahepatic cholestasis of pregnancy, third trimester
ICD-10 O26.643 is a billable code used to indicate a diagnosis of intrahepatic cholestasis of pregnancy, third trimester.
Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder that occurs during pregnancy, characterized by intense itching and elevated bile acids in the bloodstream. It typically manifests in the third trimester and can lead to complications for both the mother and fetus. The exact etiology is not fully understood, but it is believed to involve hormonal changes and genetic predisposition. Maternal symptoms include pruritus, particularly on the palms and soles, and potential jaundice. The condition is associated with an increased risk of preterm birth, fetal distress, and stillbirth. Management often includes monitoring bile acid levels, symptom relief, and in some cases, early delivery to mitigate risks to the fetus. Close collaboration between obstetricians and maternal-fetal medicine specialists is essential for optimal outcomes.
Detailed documentation of maternal symptoms, laboratory results, and management plans is essential. This includes bile acid levels, liver function tests, and any interventions performed.
Common scenarios include a pregnant patient presenting with itching and elevated bile acids, requiring monitoring and potential early delivery.
Consideration of the timing of delivery and monitoring of fetal well-being is crucial.
High-risk pregnancy documentation needs to include comprehensive assessments of both maternal and fetal health, including ultrasound findings and fetal monitoring.
Complex scenarios may involve managing a patient with ICP who has a history of stillbirth or other complications.
Close monitoring of fetal heart rate and potential interventions to prevent adverse outcomes.
Used for follow-up visits to monitor ICP and manage symptoms.
Documentation must include assessment of symptoms, lab results, and management plan.
Obstetricians should ensure comprehensive documentation to support the level of service billed.
Common symptoms include intense itching, particularly on the palms and soles, and in some cases, jaundice. These symptoms typically arise in the third trimester and can significantly impact the quality of life for the mother.
