Hyperemesis gravidarum with metabolic disturbance

This code signifies severe, persistent nausea and vomiting during pregnancy that leads to significant fluid and electrolyte imbalances, acid-base disturbances, or other metabolic derangements. It represents a more severe form of hyperemesis gravidarum where the patient's metabolic state is compromised.

Apply this code when documentation explicitly states hyperemesis gravidarum accompanied by evidence of metabolic disturbance, such as dehydration requiring IV fluids, electrolyte abnormalities (e.g., hypokalemia, hyponatremia), or acid-base imbalances (e.g., metabolic alkalosis). This code is appropriate when the metabolic impact of the hyperemesis is clearly documented.

• Ensure physician documentation specifically mentions "metabolic disturbance" or details the specific metabolic derangements (e.g., dehydration, electrolyte imbalance) in conjunction with hyperemesis.
• Do not use this code for uncomplicated hyperemesis gravidarum without documented metabolic compromise; refer to O21.0 or O21.9.
• Sequence this code as the principal diagnosis when it is the primary reason for the encounter, followed by codes for specific metabolic complications if applicable.