Uterine size-date discrepancy, unspecified trimester

This code signifies a discrepancy between the estimated gestational age based on the last menstrual period (LMP) or early ultrasound and the uterine size as measured during a physical examination, where the specific trimester of pregnancy is not documented. This can manifest as either a fundal height measurement that is larger or smaller than expected for the calculated gestational age.

Use this code when the provider's documentation indicates a uterine size-date discrepancy but does not specify the trimester (e.g., "uterine size inconsistent with dates, trimester unknown"). This code is appropriate when the exact cause of the discrepancy is still under investigation or not yet determined.

• Only use this code when the trimester is truly unspecified in the medical record.
• If the trimester is documented, select the more specific O26.841, O26.842, or O26.843.
• Do not use this code if a definitive diagnosis explaining the discrepancy (e.g., polyhydramnios, intrauterine growth restriction, multiple gestation) has been established.