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2025 ICD-10-CM code O99.61

This code classifies diseases of the digestive system that complicate pregnancy.

Adhere to the official ICD-10-CM coding guidelines.Always ensure that the correct trimester subcode (O99.611, O99.612, O99.613) is used.Use additional codes to specify the underlying digestive disease as needed.

Modifiers may apply depending on the specific circumstances of the encounter and the services provided.Refer to the current CPT and modifier guidelines for further details.

Medical necessity will be determined by the severity and impact of the digestive disease on the patient's health and the pregnancy.Documentation should clearly illustrate the need for treatment and the potential risks of delaying or forgoing treatment.

Obstetrician-Gynecologists and Gastroenterologists may share responsibility based on the specific digestive system disease.

IMPORTANT:Further specification of the digestive system disease using codes from chapter K (Diseases of the digestive system) is recommended.If the primary reason for maternal care is due to suspected fetal involvement, codes O35-O36 should be used instead.

In simple words: This code is for digestive problems that happen during pregnancy, making the pregnancy more difficult or needing extra medical care.It only applies to the mother, not the baby.

ICD-10-CM code O99.61 denotes diseases of the digestive system that complicate a pregnancy.This includes conditions that are either directly caused by the pregnancy, worsened by it, or are a primary reason for obstetrical care during pregnancy.This code should only be used on maternal records, never on newborn records.Additional codes, such as from category Z3A (Weeks of gestation), can be used to specify the gestational week if known.The code excludes conditions such as hemorrhoids (O22.4-), liver and biliary tract disorders (O26.6-), and conditions where the maternal care reason is suspected fetal involvement (O35-O36).

Example 1: A pregnant woman develops severe gastroesophageal reflux disease (GERD) during her second trimester, requiring medication and close monitoring.Code O99.612 would be appropriate, along with a code specifying the GERD., A pregnant patient experiences an acute appendicitis requiring an appendectomy during the third trimester.Code O99.613 would be assigned along with the procedure code for the appendectomy., A pregnant woman is hospitalized for severe nausea and vomiting (hyperemesis gravidarum) that has led to significant dehydration and weight loss.Code O99.61 (with appropriate trimester specification) could be used along with codes describing the severity of the hyperemesis.

Detailed documentation is crucial.This should include a complete history of the digestive complaint, its onset during pregnancy, severity, treatment, response to treatment, and any impact on the pregnancy.Appropriate documentation from specialist consultations (e.g., gastroenterology) should be included.Specify the trimester.

** This code is for use only on maternal records, never on newborn records.Always code the underlying digestive disease in addition to O99.61.

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