2025 ICD-10-CM code O14
Pre-eclampsia.Excludes pre-existing hypertension with pre-eclampsia.
Modifiers may be applicable depending on the specific services provided. Consult your local payer guidelines for details.
Medical necessity for pre-eclampsia coding is established by the presence of hypertension and proteinuria after 20 weeks of gestation, posing a significant risk to both the mother and fetus.The severity of the condition dictates the level of medical intervention and justifies the coding.
Obstetrician-gynecologists, family physicians, and other healthcare professionals involved in prenatal care are responsible for diagnosing and managing pre-eclampsia.This involves regular monitoring of blood pressure and urine, and appropriate interventions based on the severity of the condition.
- Chapter 15: Pregnancy, childbirth and the puerperium (O00-O9A)
- O10-O16 (Edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium)
In simple words: Pre-eclampsia is a condition that can happen during pregnancy, causing high blood pressure and protein in the urine. It can range from mild to severe and can affect both the mother and the baby.It usually starts after the 20th week of pregnancy.
Pre-eclampsia is a pregnancy-specific condition characterized by hypertension (high blood pressure) and proteinuria (protein in the urine) developing after 20 weeks of gestation.It can range in severity from mild to severe, potentially leading to serious complications for both the mother and the fetus.The diagnosis requires the presence of both hypertension and proteinuria, along with other potential symptoms like edema (swelling), headache, visual disturbances, and abdominal pain.Pre-existing hypertension with superimposed pre-eclampsia is coded differently.
Example 1: A 32-year-old woman at 34 weeks gestation presents with elevated blood pressure and protein in her urine.She is diagnosed with severe pre-eclampsia and admitted for monitoring and potential delivery., A 28-year-old woman at 26 weeks gestation develops a headache, visual disturbances, and swelling in her hands and feet. Blood pressure and urine testing confirms pre-eclampsia, requiring close monitoring and management., A 35-year-old woman with a history of hypertension presents at 28 weeks gestation.She experiences worsening hypertension and proteinuria, indicating superimposed pre-eclampsia, necessitating immediate medical intervention.
* Blood pressure readings (at least two readings taken at least 6 hours apart)* Urine analysis showing proteinuria (quantification of protein is helpful)* Gestational age at diagnosis* Presence and severity of other symptoms (edema, headache, visual disturbances, etc.)* Laboratory tests (blood tests such as liver and kidney function)* Details of treatment and management* Fetal monitoring data.
** Accurate documentation of the gestational age and severity of pre-eclampsia is crucial for proper coding and reimbursement.This information should be clearly documented in the medical record.
- Payment Status: Active
- Specialties:Obstetrics and Gynecology
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center