Question 1

What is ICD-10 code O13?

Accepted Answer

O13 is the ICD-10-CM diagnosis code for gestational [pregnancy-induced] hypertension without significant proteinuria. O13 sits in the ICD-10-CM chapter for pregnancy, childbirth and the puerperium (o00-o9a), within the section covering edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium (o10-o16).

O13 is a non-billable category for gestational [pregnancy-induced] hypertension without significant proteinuria. Move through the official child-code path until the documented detail supports a reportable code.

Question 2

Is O13 an HCC code?

Accepted Answer

O13 is a non-billable header code. Choose the billable child code supported by the documentation, then check that child's current V28 mapping.

Question 3

Is O13 billable?

Accepted Answer

No. O13 is a header (non-billable) ICD-10-CM code. Header codes sit at a higher level of the diagnosis hierarchy and exist to organize a family of more specific child codes. Per ICD-10-CM coding guidelines, a header code cannot be reported on a claim as the diagnosis, coders must select a billable child code from the O13 hierarchy that matches the highest level of specificity supported by the provider's documentation. Payers reject header codes submitted as the primary diagnosis.

Question 4

Which HCC does O13 map to under V28?

Accepted Answer

O13 is not billable. Choose a billable child code before checking its V28 mapping.

Question 5

What RAF reference is published for O13?

Accepted Answer

O13 is not billable. Choose a billable child code before checking a V28 reference coefficient.

Question 6

What is the V28 vs V24 difference for O13?

Accepted Answer

O13 is not billable. Choose a billable child code before comparing V28 with a historical V24 reference.

Question 7

What documentation supports O13?

Accepted Answer

O13 is a non-billable category for gestational [pregnancy-induced] hypertension without significant proteinuria. Move through the official child-code path until the documented detail supports a reportable code. For this DOS, capture the provider's current assessment and the care action documented for gestational [pregnancy-induced] hypertension without significant proteinuria. Keep the checklist tied to the note. Do not swap O13 with O13.1. The FY2026 tabular describes O13.1 as gestational [pregnancy-induced] hypertension without significant proteinuria, first trimester. Follow the documented detail. O13 is not billable. Choose the supported billable child code before checking mapping or documentation requirements.

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O13

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O13 ICD-10-CM Code: Gestational [pregnancy-induced] hypertension without significant proteinuria