ICD-10 Coding for Pregnancy Hypertension(O13.1, O13.2, O13.3)
Complete ICD-10-CM coding and documentation guide for Pregnancy Hypertension. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pregnancy Hypertension
O13.1-O13.5Primary Range
Gestational hypertension without significant proteinuria
Primary range for gestational hypertension occurring after 20 weeks of gestation without proteinuria.
Pre-existing hypertension complicating pregnancy
Used for hypertension that existed before pregnancy or diagnosed before 20 weeks of gestation.
Pre-eclampsia
Used when hypertension is accompanied by significant proteinuria or end-organ dysfunction.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| O13.1 | Gestational hypertension, first trimester | For new-onset hypertension in the first trimester without proteinuria. |
|
| O13.2 | Gestational hypertension, second trimester | For new-onset hypertension in the second trimester without proteinuria. |
|
| O13.3 | Gestational hypertension, third trimester | For new-onset hypertension in the third trimester without proteinuria. |
|
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 gestational hypertension
Essential facts and insights about Pregnancy Hypertension
Primary ICD-10-CM Codes for pregnancy hypertension
Decision Criteria
clinical Criteria
- Blood pressure readings and absence of proteinuria
documentation Criteria
- Document gestational age and blood pressure measurements
Applicable To
- Hypertension in pregnancy without proteinuria, first trimester
Clinical Validation Requirements
- Blood pressure ≥140/90 mmHg after 20 weeks of gestation
- No significant proteinuria (PCR <30 mg/mmol)
Code-Specific Risks
- Misclassification if proteinuria is present
- Incorrect trimester documentation
Coding Notes
- Ensure accurate documentation of gestational age and absence of proteinuria.
O13.2 - Gestational hypertension, second trimester
For new-onset hypertension in the second trimester without proteinuria.
Applicable To
- Hypertension in pregnancy without proteinuria, second trimester
Excludes
- Pre-eclampsia (O14.-)
- Pre-existing hypertension (O10.-)
Clinical Validation Requirements
- Blood pressure ≥140/90 mmHg after 20 weeks of gestation
- No significant proteinuria (PCR <30 mg/mmol)
Coding Notes
Ensure accurate documentation of gestational age and absence of proteinuria.
O13.3 - Gestational hypertension, third trimester
For new-onset hypertension in the third trimester without proteinuria.
Applicable To
- Hypertension in pregnancy without proteinuria, third trimester
Excludes
- Pre-eclampsia (O14.-)
- Pre-existing hypertension (O10.-)
Clinical Validation Requirements
- Blood pressure ≥140/90 mmHg after 20 weeks of gestation
- No significant proteinuria (PCR <30 mg/mmol)
Coding Notes
Ensure accurate documentation of gestational age and absence of proteinuria.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Weeks of gestation
Z3A.XXDifferential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Mild to moderate pre-eclampsia
O14.0Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Pregnancy Hypertension to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O13.1.
Impact
Clinical: Misclassification of pre-eclampsia, Regulatory: Non-compliance with coding standards, Financial: Potential reimbursement issues
Mitigation Strategy
Always include proteinuria assessment in documentation, Use specific tests like PCR or 24-hour urine collection
Impact
Reimbursement: Incorrect code may affect DRG assignment, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Query provider for specific trimester to assign correct code
Impact
Inaccurate documentation of gestational age leading to incorrect coding
Mitigation Strategy
Implement mandatory fields for gestational age in EHR
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 Pregnancy Hypertension, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pregnancy Hypertension
Use these documentation templates to ensure complete and accurate documentation for Pregnancy Hypertension. These templates include all required elements for proper coding and billing.
Gestational Hypertension Documentation
Specialty: ObstetricsRequired Elements
- Gestational age
- Blood pressure readings
- Proteinuria assessment
- Laboratory results
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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