2025 ICD-10-CM code O26.859
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Pregnancy, childbirth, and the puerperium - Other maternal disorders predominantly related to pregnancy Chapter 15: Pregnancy, childbirth and the puerperium Feed
Spotting complicating pregnancy, unspecified trimester.
Medical necessity is established by the presence of vaginal bleeding during pregnancy requiring evaluation and management to rule out underlying complications that could threaten the pregnancy or the mother's health.
Obstetrician-gynecologist or other qualified healthcare provider managing the pregnancy.
In simple words: This code is for when a pregnant person has some vaginal bleeding, but the doctor doesn't know what trimester of the pregnancy it's happening in.
This code is used to classify cases of spotting (vaginal bleeding) that occur during pregnancy when the specific trimester is unknown or not specified.It's crucial to note that this code should only be used for maternal records and not for newborn records.Additional codes may be necessary to fully capture associated conditions or the gestational age.
Example 1: A 28-year-old pregnant woman presents to her obstetrician's office with light vaginal bleeding.The exact gestational age is uncertain. O26.859 is used to code the spotting., A 35-year-old woman, approximately 20 weeks pregnant, experiences minimal vaginal bleeding.Because the exact gestational age is not precisely known, and the pregnancy is in the second trimester, O26.859 is used., During a routine prenatal check-up, a 25-year-old patient reports spotting, but the ultrasound results are inconclusive about the gestational week.O26.859 accurately represents the clinical findings.
Detailed patient history including the onset, duration, amount, and character of the bleeding.Documentation should specify any associated symptoms such as cramping, pain, or other vaginal discharge.Results of any diagnostic testing such as pelvic examination, ultrasound, or laboratory tests.
** This code is particularly useful when the timing of bleeding is unclear or difficult to determine definitively.Always document the clinical findings and the clinical reasoning behind code selection.
- Payment Status: Active
- Specialties:Obstetrics and Gynecology
- Place of Service:Office, Hospital, Ambulatory Surgical Center