ICD-10 Coding for Pelvic Pain in Pregnancy(O26.7, O26.88, R10.2)
Complete ICD-10-CM coding and documentation guide for Pelvic Pain in Pregnancy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pelvic Pain in Pregnancy
O26.7-O26.9Primary Range
Maternal care for other conditions predominantly related to pregnancy
This range includes codes for conditions related to pregnancy, including pelvic pain.
Pelvic and perineal pain
This code is used for general pelvic pain not specifically related to pregnancy.
Other specified joint disorders, not elsewhere classified
Used for joint disorders of the pelvic region, often in conjunction with pregnancy-related codes.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| O26.7 | Obstetric damage to pubic symphysis | Use when there is obstetric damage to the pubic symphysis during pregnancy. |
|
| O26.88 | Other specified pregnancy-related conditions | Use for pregnancy-related pelvic girdle pain without specific trauma. |
|
| R10.2 | Pelvic and perineal pain | Use for generalized pelvic pain without obstetric cause. |
|
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 pelvic pain in pregnancy
Essential facts and insights about Pelvic Pain in Pregnancy
Primary ICD-10-CM Codes for pelvic pain pregnancy
Decision Criteria
clinical Criteria
- Presence of obstetric damage to pubic symphysis
Applicable To
- Diastasis of symphysis pubis during pregnancy
Excludes
- Non-pregnancy related pelvic pain
Clinical Validation Requirements
- Positive palpation pain at symphysis
- Positive modified Trendelenburg test
Code-Specific Risks
- Incorrectly coding non-pregnancy related pelvic pain
Coding Notes
- Ensure documentation specifies the relationship of pelvic pain to pregnancy.
O26.88 - Other specified pregnancy-related conditions
Use for pregnancy-related pelvic girdle pain without specific trauma.
Applicable To
- Pregnancy-related pelvic girdle pain
Excludes
- Pelvic pain not related to pregnancy
Clinical Validation Requirements
- Pain reproducible with P4/FABER tests
- Pain localized to SI joints/gluteal region
Coding Notes
Document specific tests and findings that confirm pregnancy-related pelvic pain.
R10.2 - Pelvic and perineal pain
Use for generalized pelvic pain without obstetric cause.
Applicable To
- General pelvic pain
Excludes
- Pregnancy-related pelvic pain
Clinical Validation Requirements
- Pain not linked to pregnancy biomechanics
Coding Notes
Ensure documentation excludes pregnancy-related causes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other specified joint disorders, not elsewhere classified
M25.85Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Pelvic Pain in Pregnancy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O26.7.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Use detailed templates for documentation, Ensure all clinical findings are recorded
Impact
Reimbursement: Incorrect coding may lead to lower reimbursement rates., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate data on pregnancy-related conditions.
Mitigation Strategy
Use O26.88 for pregnancy-related pelvic girdle pain.
Impact
Risk of audits due to incorrect use of R10.2 for pregnancy-related pain.
Mitigation Strategy
Use O26.88 for pregnancy-related pelvic girdle pain and ensure documentation supports this.
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 Pelvic Pain in Pregnancy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pelvic Pain in Pregnancy
Use these documentation templates to ensure complete and accurate documentation for Pelvic Pain in Pregnancy. These templates include all required elements for proper coding and billing.
Pregnancy-related pelvic girdle pain
Specialty: ObstetricsRequired Elements
- Pain location
- Provocative/relieving factors
- Weeks gestation at onset
- Functional impact
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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