2025 ICD-10-CM code O48.1
Prolonged pregnancy. Pregnancy continuing beyond 42 completed weeks of gestation.
No modifiers are applicable to this diagnosis code.
Medical necessity for services related to prolonged pregnancy is established by the increased risks of complications after 42 weeks, such as stillbirth, fetal distress, and meconium aspiration.Monitoring, induction of labor, and delivery are medically necessary interventions in this situation.
The obstetrician or other healthcare provider managing the pregnancy is responsible for diagnosing and managing prolonged pregnancy, including monitoring the fetus, making decisions about inducing labor, and coordinating care.
- Chapter 15: Pregnancy, childbirth and the puerperium (O00-O9A)
- O48 - Other specified problems of pregnancy, childbirth and the puerperium
In simple words: This code indicates that a pregnancy has gone past the typical 42-week due date.
This code describes a pregnancy that has extended beyond 42 completed weeks (294 days) from the first day of the last menstrual period.It is also referred to as a post-term pregnancy.
Example 1: A 42-year-old woman, pregnant with her first child (nulliparous), is seen at 42 weeks and 3 days gestation with no signs of spontaneous labor.Ultrasound confirms decreased amniotic fluid and a normal fetal heart rate.O48.1 is coded., A 28-year-old woman is at 42 weeks and 1 day gestation.She has a history of a prior post-term pregnancy. Fetal monitoring is reassuring. Induction of labor is scheduled, and O48.1 is coded., A 35-year-old woman, obese (BMI 35), presents at 42 weeks gestation with no signs of labor.Ultrasound reveals a large fetus (macrosomia).The decision is made to induce labor, and O48.1 is coded.
Documentation should include the estimated date of delivery based on last menstrual period and ultrasound, confirmation of gestation beyond 42 weeks,fetal monitoring results, and any associated clinical findings like reduced amniotic fluid or meconium staining. Clinical justification for induction of labor should also be documented if applicable.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Obstetrics, Maternal-Fetal Medicine
- Place of Service:Inpatient Hospital, Birthing Center, Outpatient Hospital