2024 ICD-10-CM Diagnosis Code O26.03

Excessive weight gain in pregnancy, third trimester

ICD-10-CM Code:
O26.03
ICD-10 Code for:
Excessive weight gain in pregnancy, third trimester
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Not chronic
Code Navigator:

Code Classification

  • Pregnancy, childbirth and the puerperium
    (O00-O9A)
    • Other maternal disorders predominantly related to pregnancy
      (O20-O29)
      • Maternal care for other conditions predominantly related to pregnancy
        (O26)

O26.03 is a billable diagnosis code used to specify a medical diagnosis of excessive weight gain in pregnancy, third trimester. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

The code O26.03 is applicable to female patients aged 12 through 55 years inclusive. It is clinically and virtually impossible to use this code on a non-female patient outside the stated age range.

The code is commonly used in ob/gyn medical specialties to specify clinical concepts such as maternal disorders related to pregnancy.

Clinical Classification

Clinical Information

  • Excessive Weight Gain in Pregnancy

    in a woman with a normal weight pre-pregnancy body mass index (bmi), i.e. 18.5-24.9, the weight gained during pregnancy exceeds a total weight gain of 35 lbs. in a woman with an underweight pre-pregnancy body mass index (bmi), i.e. less than 18.5, the weight gained during pregnancy exceeds a total weight gain of 40 lbs. in a woman with an overweight pre-pregnancy body mass index (bmi), i.e. 25.0-29.9, the weight gained during pregnancy exceeds a total weight gain of 25 lbs. in a woman with an obese pre-pregnancy body mass index (bmi), i.e. greater than 30, the weight gained during pregnancy exceeds a total weight gain of 20 lbs. these standards are supported for the whole population irrespective of height, race or ethnicity.

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

  • Maternity diagnoses - The Medicare Code Editor detects inconsistencies in maternity cases by checking a patient's age and any diagnosis on the patient's record. The maternity code edits apply to patients age ange is 9–64 years inclusive (e.g., diabetes in pregnancy, antepartum pulmonary complication).
  • Diagnoses for females only - The Medicare Code Editor detects inconsistencies between a patient’s sex and any diagnosis on the patient’s record, these edits apply to FEMALES only .

Convert O26.03 to ICD-9-CM

  • ICD-9-CM Code: 646.11 - Edema in preg-delivered
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.
  • ICD-9-CM Code: 646.13 - Edema in preg-antepartum
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.