Severe pre-eclampsia, unspecified trimester

This code signifies a severe form of pre-eclampsia, a pregnancy-specific hypertensive disorder characterized by new-onset hypertension and proteinuria, or hypertension with severe features. Severe pre-eclampsia can lead to significant maternal and fetal morbidity and mortality if not promptly managed.

Apply this code when a pregnant patient presents with severe pre-eclampsia, and the specific trimester of diagnosis or presentation is not documented. Documentation should clearly indicate the presence of severe pre-eclampsia, typically including blood pressure readings meeting severe criteria (e.g., systolic ≥160 mmHg or diastolic ≥110 mmHg) and/or severe features such as new-onset renal insufficiency, liver involvement, pulmonary edema, cerebral or visual disturbances, or thrombocytopenia.

• Do not use if the trimester is specified; instead, select the appropriate O14.1x code that includes the trimester.
• Always sequence this code as a principal diagnosis when it is the reason for the encounter.
• Ensure documentation supports the "severe" criteria, as mild pre-eclampsia (O14.0x) is a distinct diagnosis.