ICD-10 Coding for Nausea in Pregnancy(O21.0, O21.1)
Complete ICD-10-CM coding and documentation guide for Nausea in Pregnancy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Nausea in Pregnancy
O21.0-O21.9Primary Range
Excessive vomiting in pregnancy
This range covers conditions related to nausea and vomiting specifically due to pregnancy.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| O21.0 | Mild hyperemesis gravidarum | Use when the patient experiences mild nausea and vomiting without significant weight loss or metabolic disturbances. |
|
| O21.1 | Hyperemesis gravidarum with metabolic disturbance | Use when the patient experiences severe nausea and vomiting with metabolic disturbances such as electrolyte imbalance. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for nausea in pregnancy
Essential facts and insights about Nausea in Pregnancy
Primary ICD-10-CM Codes for nausea in pregnancy
Decision Criteria
clinical Criteria
- Patient presents with nausea and vomiting but no significant weight loss or lab abnormalities.
Applicable To
- Nausea and vomiting in pregnancy without metabolic disturbance
Excludes
- Nausea and vomiting unrelated to pregnancy (R11.2)
Clinical Validation Requirements
- PUQE-24 score ≤6
- Weight loss <5%
- No ketonuria or lab abnormalities
Code-Specific Risks
- Misclassification if metabolic disturbances are present but not documented.
Coding Notes
- Ensure documentation specifies the absence of metabolic disturbances.
O21.1 - Hyperemesis gravidarum with metabolic disturbance
Use when the patient experiences severe nausea and vomiting with metabolic disturbances such as electrolyte imbalance.
Applicable To
- Nausea and vomiting in pregnancy with metabolic disturbance
Excludes
- Nausea and vomiting unrelated to pregnancy (R11.2)
Clinical Validation Requirements
- PUQE-24 score ≥7
- Weight loss ≥5%
- Presence of ketonuria or electrolyte imbalance
Coding Notes
Document specific metabolic disturbances and weight loss percentage.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Nausea in Pregnancy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O21.0.
Impact
Clinical: May lead to inadequate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.
Mitigation Strategy
Use specific metrics like PUQE-24 score and weight loss percentage.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on pregnancy-related conditions.
Mitigation Strategy
Use O21.x codes unless a non-obstetric cause is confirmed.
Impact
Failure to document metabolic disturbances can lead to incorrect coding.
Mitigation Strategy
Ensure all metabolic disturbances are documented with lab results.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Nausea in Pregnancy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Nausea in Pregnancy
Use these documentation templates to ensure complete and accurate documentation for Nausea in Pregnancy. These templates include all required elements for proper coding and billing.
Severe nausea in pregnancy with metabolic disturbance
Specialty: ObstetricsRequired Elements
- PUQE-24 score
- Weight loss percentage
- Presence of ketonuria
- Electrolyte levels
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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