O12.20 — Gestational edema with proteinuria, unspecified trimester

BillableUnspecified

Is O12.20 billable?

Yes, but O12.20 is an unspecified code. O12.20 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, O12.20 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting O12.20 — the more specific alternatives are listed below.

More specific alternatives

O12.20 at a glance

Code	O12.20
Description	Gestational edema with proteinuria, unspecified trimester
Billable	Yes
Code set	ICD-10-CM FY2027
Valid for encounters	October 1, 2026 – September 30, 2027

Which MS-DRGs does O12.20 group to?

O12.20 sits in MDC 14 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

817Other Antepartum Diagnoses with O.R. Procedures with MCCsurgical
818Other Antepartum Diagnoses with O.R. Procedures with CCsurgical
819Other Antepartum Diagnoses with O.R. Procedures without CC/MCCsurgical

How is O12.20 listed in the Alphabetic Index?

The Alphabetic Index lists these routes under O12.2, the nearest indexed parent of O12.20. Use them to find the family, then select the specific code.

Pregnancy › complicated by › proteinuria › with edema (single) (uterine)
Pregnancy › complicated by › edema › with › proteinuria (single) (uterine)
Proteinuria › gestational › complicating › pregnancy › with edema

Excludes1 — never code together — inherited from Chapter 15

The conditions below can never be reported together with O12.20 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

supervision of normal pregnancy (Z34.-)

Use additional code — inherited from Chapter 15

Report an additional code alongside O12.20 to fully describe the condition. O12.20 is sequenced first.

code, if applicable, from category Z3A, Weeks of gestation, to identify the specific week of the pregnancy, if known.

Excludes2 — not included here — inherited from Chapter 15

The conditions below are not part of O12.20, but a patient may have both at the same time. When documentation supports it, O12.20 and the excluded code may both be reported.

mental and behavioral disorders associated with the puerperium (F53.-)
obstetrical tetanus (A34)
postpartum necrosis of pituitary gland (E23.0)
puerperal osteomalacia (M83.0)

How long has O12.20 existed?

O12.20 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.