Pre-existing hypertension w pre-eclampsia, second trimester

This code signifies a pregnancy complicated by pre-eclampsia that develops in a patient with a pre-existing diagnosis of hypertension, occurring specifically during the second trimester. It indicates a superimposed pre-eclampsia on chronic hypertension, a more severe form of hypertensive disorder in pregnancy. The patient had hypertension prior to conception or before 20 weeks' gestation.

Use this code when documentation clearly states a diagnosis of pre-eclampsia occurring in a pregnant patient with a history of chronic hypertension, and the pre-eclampsia onset or diagnosis is noted during the second trimester (weeks 14 through 27+6 days). Supporting documentation includes physician notes detailing the pre-existing hypertension, the new onset of pre-eclampsia symptoms (e.g., proteinuria, new-onset hypertension, organ dysfunction), and the gestational age at diagnosis.

• Always confirm the timing of the pre-eclampsia diagnosis within the second trimester.
• Distinguish from gestational hypertension with superimposed pre-eclampsia (O11.3) or pre-eclampsia without pre-existing hypertension (O14.x).
• Sequence this code as the principal diagnosis when it is the reason for the encounter, followed by codes for any associated manifestations or complications.