2020 ICD-10-CM Diagnosis Code O94

Sequelae of complication of pregnancy, childbirth, and the puerperium

    2016 2017 2018 2019 2020 Billable/Specific Code Maternity Dx (12-55 years) Female Dx POA Exempt
  • O94 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • Short description: Sequelae of comp of pregnancy, chldbrth, and the puerperium
  • The 2020 edition of ICD-10-CM O94 became effective on October 1, 2019.
  • This is the American ICD-10-CM version of O94 - other international versions of ICD-10 O94 may differ.
ICD-10-CM Coding Rules
  • O94 is applicable to maternity patients aged 12 - 55 years inclusive.
  • O94 is applicable to female patients.
Note
  • This category is to be used to indicate conditions in
    ICD-10-CM Diagnosis Code O00

    Ectopic pregnancy

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Includes
    • ruptured ectopic pregnancy
    Use Additional
    • code from category O08 to identify any associated complication
    O00
    -
    ICD-10-CM Diagnosis Code O77

    Other fetal stress complicating labor and delivery

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    O77
    .-,
    ICD-10-CM Diagnosis Code O85

    Puerperal sepsis

      2016 2017 2018 2019 2020 Billable/Specific Code Maternity Dx (12-55 years) Female Dx
    Applicable To
    • Postpartum sepsis
    • Puerperal peritonitis
    • Puerperal pyemia
    Type 1 Excludes
    • fever of unknown origin following delivery (O86.4)
    • genital tract infection following delivery (O86.1-)
    • obstetric pyemic and septic embolism (O88.3-)
    • puerperal septic thrombophlebitis (O86.81)
    • urinary tract infection following delivery (O86.2-)
    Type 2 Excludes
    • sepsis during labor (O75.3)
    Use Additional
    • code (B95-B97), to identify infectious agent
    O85
    -
    ICD-10-CM Diagnosis Code O94

    Sequelae of complication of pregnancy, childbirth, and the puerperium

      2016 2017 2018 2019 2020 Billable/Specific Code Maternity Dx (12-55 years) Female Dx POA Exempt
    Code First
    • condition resulting from (sequela) of complication of pregnancy, childbirth, and the puerperium
    Note
    • This category is to be used to indicate conditions in O00-O77.-, O85-O94 and O98-O9A.- as the cause of late effects. The sequelae include conditions specified as such, or as late effects, which may occur at any time after the puerperium
    O94
    and
    ICD-10-CM Diagnosis Code O98

    Maternal infectious and parasitic diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Includes
    • the listed conditions when complicating the pregnant state, when aggravated by the pregnancy, or as a reason for obstetric care
    Type 2 Excludes
    • herpes gestationis (O26.4-)
    • infectious carrier state (O99.82-, O99.83-)
    • obstetrical tetanus (A34)
    • puerperal infection (O86.-)
    • puerperal sepsis (O85)
    • when the reason for maternal care is that the disease is known or suspected to have affected the fetus (O35-O36)
    Use Additional
    • code (Chapter 1), to identify specific infectious or parasitic disease
    O98
    -
    ICD-10-CM Diagnosis Code O9A

    Maternal malignant neoplasms, traumatic injuries and abuse classifiable elsewhere but complicating pregnancy, childbirth and the puerperium

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    O9A
    .- as the cause of late effects. The sequelae include conditions specified as such, or as late effects, which may occur at any time after the puerperium
Code First
Code First Help
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
  • condition resulting from (sequela) of complication of pregnancy, childbirth, and the puerperium
The following code(s) above O94 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to O94:
  • O00-O9A
    2020 ICD-10-CM Range O00-O9A

    Pregnancy, childbirth and the puerperium

    Note
    • CODES FROM THIS CHAPTER ARE FOR USE ONLY ON MATERNAL RECORDS, NEVER ON NEWBORN RECORDS
    • Codes from this chapter are for use for conditions related to or aggravated by the pregnancy, childbirth, or by the puerperium (maternal causes or obstetric causes)
    • Trimesters are counted from the first day of the last menstrual period. They are defined as follows:
    • 1st trimester- less than 14 weeks 0 days
    • 2nd trimester- 14 weeks 0 days to less than 28 weeks 0 days
    • 3rd trimester- 28 weeks 0 days until delivery
    Type 1 Excludes
    • supervision of normal pregnancy (Z34.-)
    Type 2 Excludes
    • mental and behavioral disorders associated with the puerperium (F53.-)
    • obstetrical tetanus (A34)
    • postpartum necrosis of pituitary gland (E23.0)
    • puerperal osteomalacia (M83.0)
    Use Additional
    • code from category Z3A, Weeks of gestation, to identify the specific week of the pregnancy, if known.
    Pregnancy, childbirth and the puerperium
Present On Admission
POA Help
"Present On Admission" is defined as present at the time the order for inpatient admission occurs — conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery, are considered POA.
  • O94 is considered exempt from POA reporting.
ICD-10-CM O94 is grouped within Diagnostic Related Group(s) (MS-DRG v37.0):
  • 769 Postpartum and post abortion diagnoses with o.r. Procedure
  • 776 Postpartum and post abortion diagnoses without o.r. Procedure

Convert O94 to ICD-9-CM

Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change

Diagnosis Index entries containing back-references to O94:
  • Sequelae (of) - see also condition
    • childbirth O94
    • obstetrical condition O94
    • pregnancy O94
    • puerperium O94

ICD-10-CM Codes Adjacent To O94
O92.2 Other and unspecified disorders of breast associated with pregnancy and the puerperium
O92.20 Unspecified disorder of breast associated with pregnancy and the puerperium
O92.29 Other disorders of breast associated with pregnancy and the puerperium
O92.3 Agalactia
O92.4 Hypogalactia
O92.5 Suppressed lactation
O92.6 Galactorrhea
O92.7 Other and unspecified disorders of lactation
O92.70 Unspecified disorders of lactation
O92.79 Other disorders of lactation
O94 Sequelae of complication of pregnancy, childbirth, and the puerperium
O98 Maternal infectious and parasitic diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium
O98.0 Tuberculosis complicating pregnancy, childbirth and the puerperium
O98.01 Tuberculosis complicating pregnancy
O98.011 …… first trimester
O98.012 …… second trimester
O98.013 …… third trimester
O98.019 …… unspecified trimester
O98.02 Tuberculosis complicating childbirth
O98.03 Tuberculosis complicating the puerperium
O98.1 Syphilis complicating pregnancy, childbirth and the puerperium

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.