ICD-10 Coding for Diabetes in Pregnancy

Coding Tips,

When coding from ICD-10, a primary diagnosis code must be assigned from Chapter 15, Pregnancy, Childbirth and Puerperium (O00-O9A) to describe their condition.  For diabetes, the diagnosis category that will be selected is O24, Diabetes mellitus in pregnancy, childbirth, and the puerperium.  A secondary diagnosis should be assigned to further describe the diabetes condition (E08-E13) along with the weeks of gestation at the time of care (Z3A.33).

Diabetes Mellitus - Diabetes Specificity

  • Pre-existing
  • Gestational
  • Other
  • Unspecified

Diabetes Type

  • Type 1
  • Type 2
  • Other
  • Unspecified

Time of Care - Condition

  • Pregnancy
  • Childbirth
  • Puerperium

Timing During Pregnancy

  • 1st Trimester ( less than 14 weeks 0 days )
  • 2nd  Trimester (14 weeks 0 days to less than 28 weeks 0 days )
  • 3rd  Trimester (28 weeks 0 days until delivery )
  • Unspecified

For example:  A 36 year old G2P1 at 33 weeks gestation (3rd trimester) was seen in the office today with a type II pregestational diabetes.  It is being controlled by diet and insulin as needed based on glucose checks.   The patient has no other complications of diabetes.  ICD-10 Diagnosis:

  • Pre-existing type II diabetes in pregnancy, antepartum = O24.113
  • Week of gestation in the pregnancy (Z3A. codes) = Z3A.33
  • Additional codes for any other complications related to diabetes/manifestations (E11.0 - E11.9 codes) = E11.9 (type II diabetes with no other complications)
  • Additional code for long term insulin use = Z79.4
  • Final Codes to submit:  024.113 E11.9 Z3A.33 Z79.4  

 Clearly document the specific type of diabetes (Pre-gestational, controlled by diet and/or insulin), the condition at the time of diagnosis (G2P1) and the gestational age (33 weeks gestation).

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