O24.4 ICD-10-CM Code: Gestational diabetes mellitus
Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.
Coding at a Glance
- Tabular directives
- 2 inclusion terms · 2 Excludes2
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for O24.4 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025
Notes without a marker are published on O24.4 itself; “inherited from” names the category or block whose note applies here.
Inclusion Terms
Alternative terms the tabular list files under this code.
- Diabetes mellitus arising in pregnancy
- Gestational diabetes mellitus NOS
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48) Compare O24.4 vs O30 →
- maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium (O98-O99) Compare O24.4 vs O98 →
Source: inherited from O20-O29
Coder workflow for O24.4
MedCoder structured workflow — derived from this code’s own official record
Before you code O24.4
- O24.4 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).
See the relationships section · Guide: How to choose an ICD-10-CM code →
- Confirm the condition is documented as complicating the pregnancy, childbirth, or the puerperium, and check the trimester where the code carries one and the fetus character where the category requires it. Chapter 15 codes belong on the maternal record only and take sequencing priority over codes from other chapters. It is the provider’s responsibility to state that a condition is not affecting the pregnancy; the trimester is assigned from the documentation (Guidelines I.C.15.a, I.C.15.a.1, I.C.15.a.3).
Choose the right path
- Does the documentation support one of the more specific codes beneath O24.4?
Yes → Select that code and continue the checks below on its own page.
No → O24.4 cannot be reported as written; query for the specificity its subcategory needs.
Consider O24.4. Then confirm the code is valid for the date of service in the Verify section.
Documentation check
- The provider’s diagnostic statement
- Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
- Trimester
- Assigned from the documented trimester at the encounter, or the trimester in which the condition developed for inpatient stays (Guidelines I.C.15.a.3).
Official instructions as workflow
Excludes2 — not part of O24.4(2 notes)
Coding workflow: The conditions named in this note are not included in O24.4. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
See the official tabular notes · Guidelines I.A.12.b
Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Official Coding Guidelines
Official source data — quoted verbatim from the CMS/NCHS Official Guidelines
Official source data — quoted verbatim from the CMS/NCHS Official Guidelines
Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.
Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A)
Codes for gestational diabetes are in subcategory O24.4, Gestational diabetes mellitus. No other code from category O24, Diabetes mellitus in pregnancy, childbirth, and the puerperium, should be used with a code from O24.4.
Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A)
The codes under subcategory O24.4 include diet controlled, insulin controlled, and controlled by oral hypoglycemic drugs. If a patient with gestational diabetes is treated with both diet and insulin, only the code for insulin-controlled is required. If a patient with gestational diabetes is treated with both diet and oral hypoglycemic medications, only the code for "controlled by oral hypoglycemic drugs" is required. Codes Z79.4, Long-term (current) use of insulin, Z79.84, Long-term (current) use of oral hypoglycemic drugs, and Z79.85, Long-term (current) use of injectable non-insulin antidiabetic drugs, should not be assigned with codes from subcategory O24.4.
Verify Before Coding
- Not billable as written — a more specific code is required: O24.410, O24.414, O24.415, O24.419, O24.420.
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.
Relationships & Classification
MedCoder structured relationships — computed from published CMS and AHRQ datasets
Other codes that name O24.4 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.
Referenced by 9 Excludes1 notes across 4 chapters: E08 — Diabetes mellitus due to underlying condition, E09 — Drug or chemical induced diabetes mellitus, E10 — Type 1 diabetes mellitus, E11 — Type 2 diabetes mellitus, E13 — Other specified diabetes mellitus, O99.81 — Abnormal glucose complicating pregnancy, childbirth and the puerperium, R73 — Elevated blood glucose level (via O24.-), R73.0 — Abnormal glucose, Z86.32 — Personal history of gestational diabetes.
These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.
Referenced by 1 Excludes2 note: O99.2 — Endocrine, nutritional and metabolic diseases complicating pregnancy, childbirth and the puerperium (via O24.-).
These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.
Contextual Map
Every relationship of O24.4 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.
Run O24.4 with these 9 related codes in Claim Check
Hierarchy
- O00-O9A — Chapter 15: Pregnancy, Childbirth and the Puerperium (O00-O9A) (O00-O9A)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O20-O29 — Other maternal disorders predominantly related to pregnancy[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Referenced by Excludes1 notes (9)
- E08 — Diabetes mellitus due to underlying condition[Excludes1]: “gestational diabetes (O24.4-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- E09 — Drug or chemical induced diabetes mellitus[Excludes1]: “gestational diabetes (O24.4-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- E10 — Type 1 diabetes mellitus[Excludes1]: “gestational diabetes (O24.4-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- E11 — Type 2 diabetes mellitus[Excludes1]: “gestational diabetes (O24.4-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- E13 — Other specified diabetes mellitus[Excludes1]: “gestational diabetes (O24.4-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O99.81 — Abnormal glucose complicating pregnancy, childbirth and the puerperium[Excludes1]: “gestational diabetes (O24.4-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- R73 — Elevated blood glucose level[Excludes1](via O24.-): “diabetes mellitus in pregnancy, childbirth and the puerperium (O24.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- R73.0 — Abnormal glucose[Excludes1]: “gestational diabetes (O24.4-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- and 1 more
Referenced by Excludes2 notes
- O99.2 — Endocrine, nutritional and metabolic diseases complicating pregnancy, childbirth and the puerperium[Excludes2](via O24.-): “diabetes mellitus (O24.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Nearest codes (40)
- O24 — Diabetes mellitus in pregnancy, childbirth, and the puerperium[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O24.013 — Pre-existing type 1 diabetes mellitus, in pregnancy, third trimester[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O24.019 — Pre-existing type 1 diabetes mellitus, in pregnancy, unspecified trimester[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O24.02 — Pre-existing type 1 diabetes mellitus, in childbirth[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O24.03 — Pre-existing type 1 diabetes mellitus, in the puerperium[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O24.1 — Pre-existing type 2 diabetes mellitus, in pregnancy, childbirth and the puerperium[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O24.11 — Pre-existing type 2 diabetes mellitus, in pregnancy[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O24.111 — Pre-existing type 2 diabetes mellitus, in pregnancy, first trimester[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 32 more
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
Common coding questions
Can O24.4 be billed directly?
No. O24.4 (Gestational diabetes mellitus) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, title, tabular notes and index terms Official source data
- CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Coding guidelines Official source data
- ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder structured relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
Cite this page
Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.
MedCoder.ai. "O24.4 — Gestational diabetes mellitus." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/o24.4-gestational-diabetes-mellitus
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionGestational diabetes mellitus
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to O24.4 in its code family, with their registry titles.
- O24.312 — Unspecified pre-existing diabetes mellitus in pregnancy, second trimester
- O24.313 — Unspecified pre-existing diabetes mellitus in pregnancy, third trimester
- O24.319 — Unspecified pre-existing diabetes mellitus in pregnancy, unspecified trimester
- O24.32 — Unspecified pre-existing diabetes mellitus in childbirth
- O24.33 — Unspecified pre-existing diabetes mellitus in the puerperium
- O24.41 — Gestational diabetes mellitus in pregnancy
- O24.410 — Gestational diabetes mellitus in pregnancy, diet controlled
- O24.414 — Gestational diabetes mellitus in pregnancy, insulin controlled
- O24.415 — Gestational diabetes mellitus in pregnancy, controlled by oral hypoglycemic drugs
- O24.419 — Gestational diabetes mellitus in pregnancy, unspecified control