High-Risk Pregnancy Supervision ICD-10-CM codes

Category O09 is the first-listed code for routine prenatal visits in a pregnancy the provider documents as high risk. The fourth and fifth characters give the reason: O09.0- history of infertility, O09.1- history of ectopic pregnancy, O09.21- history of preterm labor, O09.29- other poor obstetric history, O09.3- insufficient antenatal care, O09.4- grand multiparity, O09.51- elderly primigravida and O09.52- elderly multigravida (age 35 or older at the expected date of delivery), O09.61- and O09.62- young primigravida and multigravida (under 16), O09.7- social problems, O09.81- pregnancy from assisted reproductive technology, O09.82- history of in utero procedure in a previous pregnancy, O09.A- history of molar pregnancy, O09.89- other, and O09.9- unspecified.

The final character is the trimester: 1 first, 2 second, 3 third, and 0 or 9 unspecified. Trimesters are counted from the first day of the last menstrual period: first through 13 weeks 6 days, second 14 weeks to 27 weeks 6 days, third from 28 weeks. O09.90 is the unspecified fallback; a trimester-specific code such as O09.93 is expected when the dates are known. When a complication develops, the specific O10 to O9A code for that complication is added, and it may be sequenced first when it is the reason for the visit.

Z34 codes (Z34.03, Z34.83, Z34.93) are for supervision of a normal pregnancy and are never reported with an O09 code or with any other chapter 15 code. Z33.1 (pregnant state, incidental) is for encounters where the pregnancy has no bearing on the visit. Add a Z3A code (for example Z3A.20) for weeks of gestation on each prenatal encounter.