Preeclampsia and Gestational Hypertension ICD-10-CM codes

Category O14 is divided by severity: O14.0- mild to moderate preeclampsia, O14.1- severe preeclampsia (preeclampsia with severe features), O14.2- HELLP syndrome, and O14.9- unspecified preeclampsia. The final character reports timing: 0 unspecified trimester, 2 second trimester, 3 third trimester, 4 complicating childbirth, 5 complicating the puerperium. There are no first-trimester codes because preeclampsia is not diagnosed before 20 weeks. O14.93 is the default when severity is not documented; query for severity because it drives management and reimbursement.

Gestational hypertension without significant proteinuria is O13.- (for example O13.3 in the third trimester). When the patient had hypertension before the pregnancy, use O10.- for the pre-existing hypertension alone (O10.019 essential hypertension complicating pregnancy, unspecified trimester) and O11.- when preeclampsia develops on top of it. O16.- is reserved for hypertension in pregnancy that the provider does not further characterize. Do not report R03.0 or I10 for elevated blood pressure in a pregnant patient; the obstetric code takes precedence.

Eclampsia (seizures in a patient with preeclampsia) is O15.-, with O15.00 through O15.03 for pregnancy by trimester, O15.1 in labor, and O15.2 in the puerperium. Postpartum preeclampsia uses the fifth character 5 (O14.05, O14.15, O14.25, O14.95). Add a Z3A code for weeks of gestation on antepartum encounters, and on the delivery record add the Z37 outcome code.