Pruritic urticarial papules and plaques of pregnancy (PUPPP)

This code represents a common, benign, and intensely itchy skin rash that typically develops in late pregnancy. It is characterized by small, red, raised bumps and larger, hive-like patches that often begin on the abdomen and spread to the thighs and buttocks. While uncomfortable, PUPPP does not pose a risk to the mother or fetus.

Use this code when documentation clearly indicates a diagnosis of pruritic urticarial papules and plaques of pregnancy. This diagnosis is typically made clinically based on the characteristic rash and its onset during gestation. Supporting documentation should include the patient's pregnant status and a description of the skin lesions consistent with PUPPP.

• Ensure the documentation specifies the condition as occurring during pregnancy.
• Do not confuse with other dermatoses of pregnancy, such as pemphigoid gestationis, which has a different clinical presentation and prognosis.
• This code is typically a secondary diagnosis, with the primary diagnosis often related to the pregnancy itself (e.g., Z3A.xx for weeks of gestation).