Diabetes mellitus is one of the most common chronic disease in old age. In medical coding, the diagnosis coding for normal women and pregnant women has separate coding guidelines. This disease has a significant complicating factor in pregnancy.
We have learned a lot of Pregnancy ICD and CPT codes, you can find some information about them in below links.
Use of Pregnancy Complication ICD 10 codes
When to use Normal Pregnancy and Incidental Pregnancy ICD 10 codes
Twin Pregnancy ICD and CPT codes
There is a separate category of ICD 10 codes for diabetes in pregnancy condition. Pregnant women who are diabetic should be assigned a code from category O24, Diabetes mellitus in pregnancy, childbirth, and the puerperium, first, followed by the appropriate diabetes code(s) (E08–E13) from chapter 4 of ICD-10-CM.
There are specific ICD 10 codes for diabetes mellitus in pregnancy chapter, below are few examples:
O24.011–O24.03 Pre-existing type 1 diabetes mellitus
O24.011–O24.13 Pre-existing type 2 diabetes mellitus
O24.311–O24.319 Unspecified pre-existing diabetes mellitus
O24.410–O24.439 Gestational diabetes mellitus
O24.811–O24.83 Other pre-existing diabetes mellitus
O24.911–O24.93 Unspecified diabetes mellitus
Read also: Coding tips for Ectopic and Molar Pregnancy ICD and CPT codes
When to use Gestational diabetes ICD 10 codes
Use of Z codes for Screening, Insulin, hypoglycemic drugs & weeks of Gestation
There are also major use of Z codes along with diabetes mellitus diagnosis codes. The Code Z79.4, Long-term (current) use of insulin, has to be assigned if the pre-existing or unspecified diabetes mellitus is being treated with insulin. But when the insulin is used only for temporary use, do not use Z79.4, it should be used for long-term use only.
Similarly when a the patient is taking oral hypoglycemic drug like Metformin, we have to assign Z79.84, Long-term (current) use of oral hypoglycemic drugs, when the pre-existing or unspecified diabetes mell
However, neither code Z79.4 nor code Z79.84 should be assigned with codes from subcategory O24.4, Gestational diabetes. If a patient with gestational diabetes is medication controlled, the appropriate medication-controlled code O24.414, O24.415, O24.424, O24.425, O24.434, or O24.435 should be assigned instead of Z79.4 or Z79.84. Code Z86.32, Personal history of gestational diabetes, is assigned to indicate that a patient has a history of gestational diabetes in a previous pregnancy.
A pregnant patient may have an abnormal glucose tolerance and not be diagnosed with gestational diabetes. In such cases, a code from subcategory O99.81, Abnormal glucose complicating pregnancy, childbirth, and the puerperium, should be assigned instead.
When reporting complication of a pregnant patient, along with the trimester you will need to report the specific week of gestation as well. Use additional code from category Z3A (weeks of gestation) to identify the specific week of the pregnancy.
Z13.1 Encounter for screening for diabetes mellitus
Thank you for this post! I have a question about the pre-existing and unspecified diabetes in pregnancy codes. If the physician states that patient has pre-existing diabetes but doesn’t state if it is type 1 or 2, we generally default to type 2. Is this the same in the pregnancy codes? What would be the difference between O24.011 (pre-existing type 2) and O24.311 (unspecified) if the physician doesn’t list the type?
O24.011 + E11.9 or O24.311 + E11.9
Thank you!
Hi Koumba,
you have asked a very good question…as per coding guidelines…the pre-existing diabetes code (024 category) should be followed by a an diabetes code from series of E10 or E11 category code. Now, to answer your query, a unspecified pre-existing diabetes should be reported as unspecified only from 024 category, followed by a type 2 diabetes from from E11 category. We cannot assume a type 2 diabetes for coding pre-existing diabetes.
Hope this will resolve your query.