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2025 ICD-10-CM code O12.1

Gestational proteinuria is the presence of protein in the urine during pregnancy, without hypertension.

Codes from Chapter 10 (O00-O9A) are for maternal records only, never for newborns.Appropriate trimester should be specified if known.Use of additional codes (Z3A for gestational age) is recommended.

The medical necessity for coding O12.1 is established by the presence of proteinuria during pregnancy in the absence of hypertension.Monitoring is necessary to detect progression to preeclampsia or other complications. Further investigations, depending on the severity, may be deemed medically necessary.

Obstetricians and gynecologists are primarily responsible for managing gestational proteinuria.Depending on severity, consultation with nephrologists or other specialists may be necessary.

IMPORTANT:Consider additional codes from category Z3A (Weeks of gestation) to specify the week of pregnancy.Codes O12.0 (Gestational edema), O12.2 (Gestational edema with proteinuria) and other codes within the O10-O16 range may also be relevant depending on the clinical presentation.Excludes codes for conditions not directly related to pregnancy, childbirth, or the puerperium such as obstetrical tetanus (A34), postpartum necrosis of pituitary gland (E23.0), and puerperal osteomalacia (M83.0).

In simple words: Gestational proteinuria means extra protein in a pregnant person's urine, but their blood pressure is normal.This usually goes away after the baby is born, but doctors might want to do more tests to be sure everything is okay.

O12.1, Gestational proteinuria, refers to the presence of protein in the urine of a pregnant woman without accompanying hypertension.This condition is specific to pregnancy and typically resolves postpartum.It can be a sign of underlying conditions, and severity varies.The trimester of occurrence should be specified when known (using additional codes if needed) to aid in clinical management and risk assessment.Further investigation may be warranted to assess for underlying preeclampsia or other pregnancy-related complications.

Example 1: A 28-year-old woman at 32 weeks gestation presents with proteinuria on routine urinalysis. Blood pressure is normal.Further testing is done to rule out preeclampsia. O12.1 is coded., A 35-year-old primigravida at 16 weeks gestation is found to have proteinuria during a prenatal check-up. Her blood pressure is normal.This case is coded as O12.1., A 25-year-old woman at 20 weeks gestation presents with mild proteinuria, normal blood pressure and no other symptoms. This is coded as O12.1 and additional codes from Z3A to specify the week of gestation may be used.

Complete obstetrical history, including prior pregnancies, current gestational age, blood pressure readings at each visit, urinalysis results with quantification of protein, and any other relevant lab values.Physician notes should clearly document the absence of hypertension.

** The diagnosis of gestational proteinuria requires careful clinical judgment to differentiate it from other pregnancy-related hypertensive disorders.

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