ICD 10 Coding Alert

Currently, for gestational diabetes, you should use 648.8x (Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth or the puerperium; abnormal glucose tolerance; gestational diabetes) and choose the fifth digit (0-4) to indicate when the condition or complication occurred. This will be your primary code.

Example: If your ob-gyn saw a 20-week ob patient who was not diabetic before her pregnancy and she is now an insulin-dependent gestational diabetic, you should code her as 648.83 (Abnormal glucose tolerance; antepartum condition or complication). Include V58.67 (Long-term [current] use of insulin) as a secondary code as the physician is treating the gestational diabetes with insulin.

In ICD-10, you'll have specific gestational diabetes codes in category O24.4-- (Gestational diabetes mellitus). These codes are:

• O24.410, Gestational diabetes mellitus in pregnancy, diet controlled
• O24.414, ... insulin controlled
• O24.419, ... unspecified control
• O24.420, Gestational diabetes mellitus in childbirth, diet controlled
• O24.424, ... insulin controlled
• O24.429, ... unspecified control
• O24.430, Gestational diabetes mellitus in the puerperium, diet controlled
• O24.434, ... insulin controlled
• O24.439, ... unspecified control.

Documentation: The physician must document if the gestational diabetes occurs in pregnancy, childbirth, or the puerperium. He should also document how he treats the gestational diabetes"with diet or insulin.

Coder Tips: If the physician is treating the gestational diabetes patient with both diet and insulin, then you should only report the insulin-controlled code.

You should not code Z79.4 (Long-term [current] use of insulin).

You should report an abnormal glucose tolerance test in pregnancy with a code from category O99.81 (Abnormal glucose complicating pregnancy, childbirth, and the puerperium) if the provider has not documented gestational diabetes.