Pregnancy-related ICD-10-CM diagnosis code listing with coverage indicators (part 1 of 9)
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A listing of ICD-10-CM diagnosis codes related to pregnancy (supervision, hypertensive disorders, infections, diabetes, edema, preeclampsia/eclampsia, etc.) with an indicator of coverage (Y) and occasional notes; applies to claims/reimbursement processing for the Iowa Department of Health and Human Services. This window contains part 1 of 9 of the full document.
No material clinical or coverage changes in this revision.
Coverage Criteria and Code Flags
Coverage flag entries (partial)
The policy marks individual ICD-10-CM diagnosis codes with a coverage indicator shown as 'Covered? = Y' or 'Y = Y' alongside code descriptions.
Diagnosis code annotations
Some diagnosis lines include mapping annotations or equivalency notes together with the coverage flag (Y = Y).
Per-code applicability indicators
The policy uses per-code applicability indicators (Y/N) and notes retired/ended codes where applicable.
O36-series code coverage indicators
Multiple O36-series maternal care diagnosis codes are presented with a 'Y' coverage/mapping indicator.
Code list with coverage flags (excerpt)
This section provides code-level entries with brief descriptors and an associated coverage flag; no service-level medical necessity criteria are specified in these lines.
ICD-10 mapping criteria (obstetric mappings)
The document shows ICD-10 equivalency/mapping relationships alongside coverage flags for obstetric conditions.
ICD-10 code recognition/coverage
Various O-series codes across placental disorders, postpartum infections, embolism, anemia, and substance/obesity complications are shown with coverage indicators.
ICD-10 acceptance indicators for pregnancy/childbirth/puerperium complications
The policy provides acceptance indicators (Y/N) for a broad set of pregnancy-related complication ICD-10 codes spanning substance use, smoking, system-specific complications, and O9A external cause/abuse codes.
ICD-10 Code Tables and Notes
| O09.40 | Supervision of pregnancy w grand multiparity, unsp trimester |
| O10.011 | Preexisting essential hypertension complicating pregnancy, first trimester |
| O14.12 | Severe preeclampsia, second trimester |
| O24.410 | Gestational diabetes mellitus in pregnancy, diet controlled |
| O24.311 | Infection oth prt genitl trct in pregnancy, second trimester = Unsp Preexisting diabetes in pregnancy, first trimester |
| O24.420 | Gestational diabetes mellitus in pregnancy, unspecified control = Gestational diabetes mellitus in childbirth, diet controlled |
| O26.02 | Excessive weight gain in pregnancy, first trimester = Excessive weight gain in pregnancy, second trimester |
| O26.642 | Intrahepatic cholestasis of pregnancy, first/second trimester (note: mapping shown) |
| O26.711 | Intrahepatic cholestasis of pregnancy, unspecified trimester = Subluxation of symphysis (pubis) in pregnancy, first trimester (annotation shown) |
| O29.011 | Pregnancy related conditions mapping to aspiration pneumonitis due to anesthesia during pregnancy (annotated Y = Y) |
| O29.3X1 | Toxic reaction to local anesth during pregnancy, first trimester (annotated Y = Y) |
| O29.40 | Spinal and epidural anesthesia induced headache during pregnancy (annotated Y = Y) |
| O31.00X1 | Papyraceous fetus, unspecified trimester, fetus 1 (annotated Y = Y) |
| O29.8X3 | Cerebral anoxia due to anesth during preg (example listing in document) |
| O31.00X0 | Papyraceous fetus, unspecified trimester |
| O35.1XX0 | Maternal care for chromosomal abnormality in fetus (noted as Ended 9/30/2022) |
| O36.0110 | Maternal care for anti-D antibodies, first trimester |
| O36.0191 | Maternal care for anti-D antibodies, second trimester, fetus 1 |
| O36.0921 | Maternal care for other rhesus isoimmunization, second trimester, fetus 1 |
| O36.1121 | Maternal care for AntiA sensitization, second trimester, fetus 1 |
| O36.20X1 | Maternal care for hydrops fetalis, unspecified trimester, fetus 1 |
| O36.4XX1 | Maternal care for intrauterine death, fetus 1 |
| O36.5111 | Maternal care for known or suspected placental insufficiency, first trimester, fetus 1 |
| O36.5114 | Maternal care for hydrops fetalis, first trimester, fetus 4 (mapping shown) |
| O36.5120 | Maternal care for known or suspected placental insufficiency, second trimester, unspecified (mapping shown) |
| O36.5920 | Maternal care for other or suspected poor fetal growth, second trimester, unspecified (mapping shown) |
| O36.60X0 | Maternal care for excess fetal growth, unspecified trimester, unspecified fetus (mapping shown) |
| O36.70X0 | Maternal care for viable fetus in abdominal pregnancy, unspecified trimester, unspecified fetus (mapping shown) |
| O36.8120 | Decreased fetal movements, second trimester, unspecified (mapping shown) |
| O41.00X0 | Oligohydramnios, unspecified trimester |
| O41.01X1 | Oligohydramnios, first trimester, fetus 1 |
| O36.8192 | Decreased fetal movements, unspecified/second trimester (various fetus designations shown) |
| O41.1031 | Infection of amniotic sac and membranes, third trimester, fetus 1 (example) |
| O41.1221 | Chorioamnionitis, second trimester, fetus 1 (example) |
| O41.1230 | Chorioamnionitis, second trimester, other fetus = Chorioamnionitis, third trimester, not applicable or unsp |
| O41.1231 | Chorioamnionitis, second trimester, other fetus = Chorioamnionitis, third trimester, fetus 1 |
| O41.1410 | Chorioamnionitis, second trimester, other fetus = Placentitis, first trimester, not applicable or unspecified |
| O41.1430 | Placentitis, second trimester, other fetus = Placentitis, third trimester, not applicable or unspecified |
| O42.00 | Disorder of amniotic fluid and membrns, unsp = Premature ROM (general mapping shown) |
| O42.012 | Preterm premature ROM, onset labor w/n 24 hours of rupture, second trimester |
| O43.211 | Placenta accreta, first trimester |
| O43.221 | Placenta accreta, unspecified trimester = Placenta increta, first trimester (and related increta/percreta mappings) |
| O43.221 | Placenta increta, first trimester (mapped from placenta accreta unspecified trimester) |
| O43.222 | Placenta increta, second trimester |
| O43.223 | Placenta increta, third trimester |
| O43.229 | Placenta increta, unspecified trimester |
| O43.231 | Placenta percreta, first trimester |
| O43.232 | Placenta percreta, second trimester |
| O43.233 | Placenta percreta, third trimester |
| O43.239 | Placenta percreta, unspecified trimester |
| O86.11 | Cervicitis following delivery |
| O86.12 | Endometritis following delivery |
| O86.20 | Urinary tract infection following delivery, unspecified |
| O86.21 | Infection of kidney following delivery |
| O86.22 | Infection of bladder following delivery |
| O88.111 | Amniotic fluid embolism in pregnancy, first trimester |
| O88.112 | Amniotic fluid embolism in pregnancy, second trimester |
| O88.113 | Amniotic fluid embolism in pregnancy, third trimester |
| O88.119 | Amniotic fluid embolism in pregnancy, unspecified trimester |
| O88.12 | Amniotic fluid embolism in childbirth |
| O88.13 | Amniotic fluid embolism in the puerperium |
| O99.011 | Anemia complicating pregnancy, first trimester |
| O99.012 | Anemia complicating pregnancy, second trimester |
| O99.013 | Anemia complicating pregnancy, third trimester |
| O99.211 | Obesity complicating pregnancy, first trimester |
| O99.212 | Obesity complicating pregnancy, second trimester |
| O99.213 | Obesity complicating pregnancy, third trimester |
| O99.310 | Alcohol use complicating pregnancy, unspecified trimester |
| O99.320 | Drug use complicating pregnancy, unspecified trimester |
| O99.325 | Drug use complicating the puerperium |
| O99.285 | Alcohol use complicating pregnancy, unspecified trimester |
| O99.310 | Alcohol use complicating pregnancy, first trimester |
| O99.311 | Alcohol use complicating pregnancy, second trimester |
| O99.312 | Alcohol use complicating pregnancy, third trimester |
| O99.313 | Alcohol use complicating childbirth |
| O99.314 | Alcohol use complicating the puerperium |
| O99.320 | Drug use complicating pregnancy, unspecified trimester |
| O99.321 | Drug use complicating pregnancy, first trimester |
| O99.322 | Drug use complicating pregnancy, second trimester |
| O99.323 | Drug use complicating pregnancy, third trimester |
| O99.324 | Drug use complicating childbirth |
| O99.325 | Drug use complicating the puerperium |
| O99.330 | Smoking (tobacco) complicating pregnancy, unspecified trimester |
| O99.331 | Smoking (tobacco) complicating pregnancy, first trimester |
| O99.332 | Smoking (tobacco) complicating pregnancy, second trimester |
| O99.334 | Smoking (tobacco) complicating pregnancy/childbirth (third trimester mapping noted) |
| O99.335 | Smoking (tobacco) complicating the puerperium |
| O99.611 | Diseases of the digestive system complicating pregnancy, first trimester |
| O99.613 | Diseases of the digestive system complicating pregnancy, third trimester |
| O99.62 | Diseases of the digestive system complicating childbirth |
| O99.63 | Diseases of the digestive system complicating the puerperium |
| O99.810 | Abnormal glucose complicating pregnancy |
| O99.820 | Streptococcus B carrier state complicating pregnancy |
| O9A.111 | Malignant neoplasm complicating pregnancy, first trimester |
| O9A.112 | Malignant neoplasm complicating pregnancy, second trimester |
| O9A.113 | Malignant neoplasm complicating pregnancy, third trimester |
| O9A.211 | Injury/poisoning/other consequences of external causes complicating pregnancy, first trimester |
| O9A.311 | Physical abuse complicating pregnancy, first trimester |
| O9A.411 | Sexual abuse complicating pregnancy, first trimester |
| O9A.511 | Psychological abuse complicating pregnancy, first trimester |
Provider Action Items and Billing Guidance
ICD-10 coverage indicators (partial list)
O09.40 — Supervision of pregnancy with grand multiparity, unspecified trimester; Covered? = Y. O09.41 — Supervision of pregnancy with grand multiparity, first trimester; Covered? = Y. O09.42 — Supervision of pregnancy with grand multiparity, second trimester; Covered? = Y. O09.43 — Supervision of pregnancy with grand multiparity, third trimester; Covered? = Y. O09.511 — Supervision of elderly primigravida, first trimester; Covered? = Y. O09.512 — Supervision of elderly primigravida, second trimester; Covered? = Y. O09.513 — Supervision of elderly primigravida, third trimester; Covered? = Y. O09.519 — Supervision of elderly primigravida, unspecified trimester; Covered? = Y. O09.521 — Supervision of elderly multigravida, first trimester; Covered? = Y. O09.522 — Supervision of elderly multigravida, second trimester; Covered? = Y. O09.523 — Supervision of elderly multigravida, third trimester; Covered? = Y. O09.529 — Supervision of elderly multigravida, unspecified trimester; Covered? = Y.
ICD-10 pregnancy diagnosis mappings
O24.311 — Infection other part genital tract in pregnancy, second trimester = Unspecified preexisting diabetes in pregnancy, first trimester; Y = Y. O24.312 — Infection other part genital tract in pregnancy, second trimester = Unspecified preexisting diabetes in pregnancy, second trimester; Y = Y. O24.313 — Infection other part genital tract in pregnancy, second trimester = Unspecified preexisting diabetes in pregnancy, third trimester; Y = Y. O24.319 — Infection other part genital tract in pregnancy, second trimester = Unspecified preexisting diabetes in pregnancy, unspecified trimester; Y = Y. O24.32 — Infection other part genital tract in pregnancy, second trimester = Unspecified preexisting diabetes mellitus in childbirth; Y = Y. O24.33 — Infection other part genital tract in pregnancy, second trimester = Unspecified preexisting diabetes mellitus in the puerperium; Y = Y. O24.410 — … = Gestational diabetes mellitus in pregnancy, diet controlled; Y = Y. O24.414 — … = Gestational diabetes in pregnancy, insulin controlled; Y = Y. (Mappings and Y flags shown in document.)
Diagnosis code applicability
Document lists individual ICD-10 diagnosis codes with payer applicability indicators (Y/Y pattern) used to denote recognition/coverage for each listed diagnosis (examples shown include O29.8X9 and O29.90 annotated Y = Y). Some lines show blank or historical annotations for retired codes.
- O29.8X9 — Cerebral anoxia due to anesthesia during pregnancy = Other complication of anesthesia during pregnancy, unspecified trimester; Y = Y.
- O29.90 — Cerebral anoxia due to anesthesia during pregnancy = Unspecified complication of anesthesia during pregnancy, unspecified trimester; Y = Y.
O36 diagnosis code mappings snippet
Multiple O36-series maternal care codes are shown with mapping text and 'Y' coverage indicators for anti-D antibodies and rhesus isoimmunization (examples include O36.0191–O36.0195 and O36.0910–O36.0912).
- O36.0191–O36.0195 — Maternal care for anti-D antibodies (second trimester) for fetus 1–5; Y = Y.
- O36.0199 — Maternal care for anti-D antibodies, other; Y = Y.
- O36.0910–O36.0912 — Maternal care mapping entries for other rhesus isoimmunization; Y = Y.
ICD-10 O36 mappings (excerpt)
Excerpt continues O36 mappings showing Y = Y indicators for placental insufficiency and other maternal-fetal conditions (examples: O36.5114, O36.5115).
- O36.5114 — Maternal care for known or suspected placental insufficiency, first trimester, fetus 4; Y = Y.
- O36.5115 — Maternal care for hydrops fetalis, first trimester, other = maternal care for known or suspected placental insufficiency, fetus 5; Y = Y.
ICD-10-CM code list — maternal/fetal problems
ICD-10-CM maternal/fetal problem codes are listed with short descriptors and Y = Y coverage flags (examples include decreased fetal movements and related O36 series codes).
- O36.8192–O36.8195 — Decreased fetal movements (various fetus designations); Y = Y.
- O36.8199 — Decreased fetal movements, other fetus; Y = Y.
- O36.8910–O36.8914 — Decreased fetal movements mapped to maternal care for other fetal problems; Y = Y.
ICD-10 chorioamnionitis mappings
Chorioamnionitis code lines are presented with equivalency mappings and Y = Y indicators (examples: O41.1230–O41.1235, O41.1239, O41.1290–O41.1292).
- O41.1230–O41.1235 — Chorioamnionitis, second trimester, other fetus = Chorioamnionitis, third trimester / fetus-specific mappings; Y = Y.
- O41.1239 — Chorioamnionitis, other fetus; Y = Y.
- O41.1290–O41.1292 — Chorioamnionitis mappings to unspecified/unspecified fetus codes; Y = Y.
Placentitis and related mappings
Placentitis and related placental infection codes are listed with mapping equivalencies and Y = Y indicators (examples include O41.1430–O41.1435 and O41.1439–O41.1493).
- O41.1430–O41.1435 — Placentitis, second trimester, other fetus = Placentitis third trimester / fetus-specific mappings; Y = Y.
- O41.1439 — Placentitis, other fetus; Y = Y.
- O41.1490–O41.1493 — Placentitis mapped to unspecified trimester/fetus codes; Y = Y.
Amniotic fluid/membrane disorders and PROM mappings
Codes for disorders of amniotic fluid and premature rupture of membranes (O42 series) are listed with mapping notes and Y = Y indicators (examples include O42.00, O42.011–O42.019, O42.02, O42.10, O42.111–O42.112).
- O42.00 — Disorder of amniotic fluid and membranes, unspecified; Y = Y.
- O42.011–O42.013 — Preterm premature ROM variations with onset labor within 24 hours of rupture; Y = Y.
- O42.02 — Full-term premature ROM mapping; Y = Y.
- O42.10–O42.112 — PROM variations with onset labor >24 hours following rupture; Y = Y.
Placental disorder codes (sample)
Placental disorder codes (accreta/increta/percreta and related infarction codes) are shown with mappings and Y = Y recognition flags (examples include O43.221–O43.239 and O43.811–O43.819).
- O43.221–O43.229 — Placenta accreta mapped to placenta increta (various trimesters); Y = Y.
- O43.231–O43.239 — Placenta accreta mapped to placenta percreta (various trimesters); Y = Y.
- O43.811–O43.819 — Placental infarction mappings; Y = Y.
Post-delivery infection codes
Post-delivery infection codes and genitourinary infection following delivery are listed with Y = Y recognition flags (examples include O86.11, O86.12, O86.20 and other genital tract infection codes).
- O86.11 — Cervicitis following delivery; Y = Y.
- O86.12 — Endometritis following delivery; Y = Y.
- O86.20 — Urinary tract infection following delivery, unspecified; Y = Y.
- Other infection of genital tract following delivery — Y = Y.
Substance use complicating pregnancy codes
Alcohol and drug use complicating pregnancy codes are listed with Y = Y acceptance flags (examples include O99.285 and O99.310–O99.315 for alcohol; O99.320–O99.325 for drug use).
- O99.285 — Alcohol use complicating pregnancy, unspecified trimester; Y = Y.
- O99.310–O99.315 — Alcohol use complicating pregnancy/childbirth/puerperium (various trimesters); Y = Y.
- O99.320–O99.325 — Drug use complicating pregnancy/childbirth/puerperium (various trimesters); Y = Y.
Drug and tobacco use complicating pregnancy codes
Drug use and smoking/tobacco complicating pregnancy codes are listed with Y flags across the series (examples include O99.320–O99.325 for drug use and O99.330–O99.335/O99.334 for smoking).
- O99.320–O99.325 — Drug use complicating pregnancy (unspecified/trimester-specific/childbirth/puerperium); Y = Y.
- O99.330–O99.335 and O99.334 — Smoking (tobacco) complicating pregnancy across trimesters, childbirth and puerperium; Y = Y.
Smoking-related pregnancy complication codes
Numerous O99.* smoking-related complication codes are enumerated with Y = Y indicators across system-specific complication subcategories (examples include O99.334–O99.345 and O99.350–O99.351 mappings).
- O99.334–O99.345 — Smoking complicating pregnancy mapped to mental disorder, childbirth and puerperium subcategories; Y = Y.
- O99.350–O99.351 — Smoking complicating pregnancy mapped to nervous system disease subcategories; Y = Y.
Other specified diseases and external causes complicating pregnancy codes
Other specified disease and external-cause codes (O9A.*) for complications of pregnancy, childbirth and the puerperium are listed with Y = Y recognition flags (examples include O9A.111–O9A.119 for malignant neoplasm and O9A.211–O9A.219/O9A.22–O9A.23 and O9A.311–O9A.313 for injuries and abuse).
- O9A.111–O9A.119 — Malignant neoplasm complicating pregnancy (various trimesters); Y = Y.
- O9A.211–O9A.219 and O9A.22–O9A.23 — Injury/poisoning/external causes complicating pregnancy/childbirth/puerperium; Y = Y.
- O9A.311–O9A.313 — Physical abuse complicating pregnancy (various trimesters); Y = Y.
Definitions and Notation
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