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ICD-10/O13.5

O13.5 ICD-10-CM Code: Gestational [pregnancy-induced] hypertension without significant proteinuria, complicating the puerperium

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 769 — POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES (MDC 14)
  • MS-DRG 776 — POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES (MDC 14)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Official Registry Overview & Definition

Gestational [pregnancy-induced] hypertension without significant proteinuria, complicating the puerperium is a billable ICD-10-CM diagnosis code (O13.5).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for O13.5 in the official ICD-10-CM tabular list.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • gestational hypertension NOS
  • transient hypertension of pregnancy

Change history

  • FY2017 — 2016-10-01
    Added to the code set
    Gestational [pregnancy-induced] hypertension without significant proteinuria, complicating the puerperium
    FY2017 changes

Verify Before Coding

  • Age-restricted: the Medicare Code Editor lists this as a maternity (age 9-64) diagnosis; other ages are presumed incorrect.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Contextual Map

Every relationship of O13.5 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

  • O00-O9A — Chapter 15: Pregnancy, Childbirth and the Puerperium (O00-O9A) (O00-O9A) [Hierarchy]
  • O10-O16 — Edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium [Hierarchy]
  • O13 — Clinical Diagnosis [Hierarchy]

Referenced by Excludes1 notes

  • I10 — Essential (primary) hypertension [Excludes1](via O13.-): “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)” · check together

Referenced by Excludes2 notes

  • I10-I1A — Hypertensive diseases (I10-I1A) [Excludes2](via O13.-): “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)” · check together
  • I11 — Hypertensive heart disease [Excludes2](via O13.-): “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)” · check together
  • I12 — Hypertensive chronic kidney disease [Excludes2](via O13.-): “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)” · check together
  • I13 — Hypertensive heart and chronic kidney disease [Excludes2](via O13.-): “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)” · check together
  • I15 — Secondary hypertension [Excludes2](via O13.-): “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)” · check together
  • I16 — Hypertensive crisis [Excludes2](via O13.-): “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)” · check together
  • I1A — Other hypertension [Excludes2](via O13.-): “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)” · check together

Clinical classification (CCSR)

  • PRG020 — Hypertension and hypertensive-related conditions complicating pregnancy; childbirth; and the puerperium [CCSR]
  • CIR008 — Hypertension with complications and secondary hypertension [CCSR]
  • PRG027 — Complications specified during the puerperium [CCSR]

Potential MS-DRG

  • DRG 769 — POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES [MS-DRG]: “POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES (MDC 14)”
  • DRG 776 — POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES [MS-DRG]: “POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES (MDC 14)”

MDC crossing · procedures (94)

  • MDC 14 — Pregnancy, Childbirth and the Puerperium [MDC crossing]: “Pregnancy, Childbirth and the Puerperium — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 0U570ZZ — Destruction of Bilateral Fallopian Tubes, Open Approach [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Open Approach — grouped in MDC 14, the procedure side of this code's crossing.” · check together
  • 0U573ZZ — Destruction of Bilateral Fallopian Tubes, Percutaneous Approach [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Percutaneous Approach — grouped in MDC 14, the procedure side of this code's crossing.” · check together
  • 0U574ZZ — Destruction of Bilateral Fallopian Tubes, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Percutaneous Endoscopic Approach — grouped in MDC 14, the procedure side of this code's crossing.” · check together
  • 0U577ZZ — Destruction of Bilateral Fallopian Tubes, Via Natural or Artificial Opening [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Via Natural or Artificial Opening — grouped in MDC 14, the procedure side of this code's crossing.” · check together
  • 0U578ZZ — Destruction of Bilateral Fallopian Tubes, Via Natural or Artificial Opening Endoscopic [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Via Natural or Artificial Opening Endoscopic — grouped in MDC 14, the procedure side of this code's crossing.” · check together
  • and 89 more

Index entries

  • Hypertension, hypertensive (accelerated) (benign) (essential) (idiopathic) (malignant) (systemic), gestational (without significant proteinuria) (pregnancy-induced) (transient), complicating, puerperium[Index term]

Nearest codes

  • O13 — Gestational [pregnancy-induced] hypertension without significant proteinuria [Sibling]
  • O13.1 — Gestational [pregnancy-induced] hypertension without significant proteinuria, first trimester [Sibling]
  • O13.2 — Gestational [pregnancy-induced] hypertension without significant proteinuria, second trimester [Sibling]
  • O13.3 — Gestational [pregnancy-induced] hypertension without significant proteinuria, third trimester [Sibling]
  • O13.4 — Gestational [pregnancy-induced] hypertension without significant proteinuria, complicating childbirth [Sibling]
  • O13.9 — Gestational [pregnancy-induced] hypertension without significant proteinuria, unspecified trimester [Sibling]

Change history

  • FY2017 — Added to the code set [Change history]

Referenced by Other Codes

Clinical classification (AHRQ CCSR):PRG020 — Hypertension and hypertensive-related conditions complicating pregnancy; childbirth; and the puerperium (default); CIR008 — Hypertension with complications and secondary hypertension; PRG027 — Complications specified during the puerperium.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Potential MS-DRG Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 2 MS-DRGs: DRG 769 (MDC 14), DRG 776 (MDC 14).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Official ICD-10-CM tabular notes on other codes that name O13.5 or its code family.

1 Excludes1 notes: I10 (via O13.-).

7 Excludes2 notes: I10-I1A (via O13.-), I11 (via O13.-), I12 (via O13.-), I13 (via O13.-), I15 (via O13.-), I16 (via O13.-), I1A (via O13.-).

Nearest Codes in This Family

Official ICD-10-CM classifications closest to O13.5 in its code family, with their registry titles.

  • O13 — Gestational [pregnancy-induced] hypertension without significant proteinuria
  • O13.1 — Gestational [pregnancy-induced] hypertension without significant proteinuria, first trimester
  • O13.2 — Gestational [pregnancy-induced] hypertension without significant proteinuria, second trimester
  • O13.3 — Gestational [pregnancy-induced] hypertension without significant proteinuria, third trimester
  • O13.4 — Gestational [pregnancy-induced] hypertension without significant proteinuria, complicating childbirth
  • O13.9 — Gestational [pregnancy-induced] hypertension without significant proteinuria, unspecified trimester

View all codes in the O13 family

Indexed Clinical Terms (1)

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code.

  • Hypertension, hypertensive (accelerated) (benign) (essential) (idiopathic) (malignant) (systemic), gestational (without significant proteinuria) (pregnancy-induced) (transient), complicating, puerperium