Gestational [pregnancy-induced] edema and proteinuria without hypertension
In Edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium (O10-O16), chapter 15: Pregnancy, Childbirth and the Puerperium
18 billable codes under O12: 6 are a CC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.
Advertisements
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
Coding of obstetric cases with O00-O9A codes: sequencing priority, trimester and fetus characters, principal diagnosis selection, delivery outcome, and pregnancy-related complications.
- General Rules for Obstetric Cases (page 63)
- Selection of OB Principal or First-listed Diagnosis (page 64)
- Pre-existing conditions versus conditions due to the pregnancy (page 65)
- Pre-existing hypertension in pregnancy (page 66)
- Fetal Conditions Affecting the Management of the Mother (page 66)
- HIV Infection in Pregnancy, Childbirth and the Puerperium (page 66)
- Diabetes mellitus in pregnancy (page 66)
- Long term use of insulin and oral hypoglycemics (page 67)
All codes under O12
O12 can't be used on a claim. Pick a billable code below; grey headings group them.
- O12.0Gestational edema
- O12.00Gestational edema, unspecified trimester
- O12.01Gestational edema, first trimester
- O12.02Gestational edema, second trimester
- O12.03Gestational edema, third trimester
- O12.04Gestational edema, complicating childbirth
- O12.05Gestational edema, complicating the puerperium
- O12.1Gestational proteinuria
- O12.10Gestational proteinuria, unspecified trimester
- O12.11Gestational proteinuria, first trimester
- O12.12Gestational proteinuria, second trimester
- O12.13Gestational proteinuria, third trimester
- O12.14Gestational proteinuria, complicating childbirth
- O12.15Gestational proteinuria, complicating the puerperium
- O12.2Gestational edema with proteinuria
- O12.20Gestational edema with proteinuria, unspecified trimester
- O12.21Gestational edema with proteinuria, first trimester
- O12.22Gestational edema with proteinuria, second trimester
- O12.23Gestational edema with proteinuria, third trimester
- O12.24Gestational edema with proteinuria, complicating childbirth
- O12.25Gestational edema with proteinuria, complicating the puerperium
O12 MS-DRGs
As the principal diagnosis, the billable codes under O12 group to these 8 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
- DRG 817 Other Antepartum Diagnoses with O.R. Procedures with MCC (12 of 18 codes)
- DRG 818 Other Antepartum Diagnoses with O.R. Procedures with CC (12 of 18 codes)
- DRG 819 Other Antepartum Diagnoses with O.R. Procedures without CC/MCC (12 of 18 codes)
- DRG 831 Other Antepartum Diagnoses without O.R. Procedures with MCC (12 of 18 codes)
- DRG 832 Other Antepartum Diagnoses without O.R. Procedures with CC (12 of 18 codes)
- DRG 833 Other Antepartum Diagnoses without O.R. Procedures without CC/MCC (12 of 18 codes)
- DRG 769 Postpartum and Post Abortion Diagnoses with O.R. Procedures (3 of 18 codes)
- DRG 776 Postpartum and Post Abortion Diagnoses without O.R. Procedures (3 of 18 codes)
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Edema
Edema means swelling caused by fluid in your body's tissues. It usually occurs in the feet, ankles and legs, but it can involve your entire body. Causes of edema include:
Read more about edema on MedlinePlusHealth Problems in Pregnancy
A health problem in pregnancy is any disease or condition that could affect your health or the health of your fetus. Some health problems may make it more likely that you will have a high-risk pregnancy. A high-risk pregnancy is one in which you, your fetus, or both are at higher risk for health problems than in a typical pregnancy.
Read more about health problems in pregnancy on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.