ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 O24.313

Billable / Specific CC

Unspecified pre-existing diabetes mellitus in pregnancy, third trimester

O24
Block
0
Synonyms
9
LCDs
3
Payer Policies
0
Linked CPTs

About ICD-10-CM O24.313

ICD-10-CM code O24.313 represents Unspecified pre-existing diabetes mellitus in pregnancy, third trimester. This is a billable/specific code in the Pregnancy, Childbirth, and Puerperium chapter (block O24). The 2026 edition of ICD-10-CM O24.313 became effective on October 1, 2025.

Coding Tips for O24.313

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

O24.313 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Pregnancy chapter (O00-O9A): trimester required

Most O codes require a 7th character indicating trimester (1 = first, 2 = second, 3 = third). Some require fetus identification character. Code O09 (supervision of high-risk pregnancy) is required as a secondary code when applicable.

Inpatient DRG Impact, CC

codes Unspecified pre-existing diabetes mellitus in pregnancy, third trimester. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for O24.313

Local Coverage Determinations (LCDs) from CMS MACs that list O24.313 as a covered diagnosis.

9 LCDs

Showing top 9. Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: HbA1c
Article ID: 56686, Effective: 2025-01-01 00:00:00, 299 covered, 0 non-covered
CPT M1211 →
CMS LCD: Billing and Coding: HbA1c
Article ID: 56686, Effective: 2025-01-01 00:00:00, 299 covered, 0 non-covered
CPT 83036 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 52996, Effective: 2025-10-01 00:00:00, 750 covered, 0 non-covered
CPT 11719 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 52996, Effective: 2025-10-01 00:00:00, 750 covered, 0 non-covered
CPT 11721 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 52996, Effective: 2025-10-01 00:00:00, 750 covered, 0 non-covered
CPT 11057 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 52996, Effective: 2025-10-01 00:00:00, 750 covered, 0 non-covered
CPT 11720 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 52996, Effective: 2025-10-01 00:00:00, 750 covered, 0 non-covered
CPT G0127 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 52996, Effective: 2025-10-01 00:00:00, 750 covered, 0 non-covered
CPT 11055 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 52996, Effective: 2025-10-01 00:00:00, 750 covered, 0 non-covered
CPT 11056 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing O24.313.

3 policies

3 Medicare

Glucose Monitor - Policy Article
Policy ID: ART-52464
Billing and Coding: Routine Foot Care
Policy ID: ART-52996
Billing and Coding: HbA1c
Policy ID: ART-56686

CPT Codes Commonly Billed with O24.313

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for O24.313

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert O24.313 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
O24.313 64801 10000
O24.313 64803 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 O24.313, Billing FAQ

Is ICD-10 code O24.313 billable? +

Yes, O24.313 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is O24.313 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What ICD-9 codes does O24.313 map to? +

Per CMS GEMs, O24.313 maps to ICD-9 codes: 64801, 64803. Useful for legacy data review and historical claim analysis.

Get the full PayerReady toolkit

Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.

Start free →

Run this code through our claim audit tool

Check NCCI bundling, MUE limits, and modifier logic before submission.

Try the auditor →

Did this page help?

Quick signal so we know what to improve.

Thanks!

If you want a code reference page that doesn't exist yet, email coding@payerready.com.

Sorry to hear that.

Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.

Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team

Faster Approvals

Ready to Cut Your Enrollment Timeline in Half?

Join providers in all 50 states who handed off credentialing to a dedicated specialist. Create your free account in minutes and start enrolling the same day.

All 50 States Covered
No Long-Term Contracts
HIPAA HIPAA Compliant Platform
Dedicated Specialist Included