O16.5 — Unspecified maternal hypertension, complicating the puerperium
Is O16.5 billable?
Yes, but O16.5 is an unspecified code. O16.5 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, O16.5 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 O16.5 — the more specific alternatives are listed below.
More specific alternatives
O16.5 at a glance
| Code | O16.5 |
|---|---|
| Description | Unspecified maternal hypertension, complicating the puerperium |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does O16.5 group to?
O16.5 sits in MDC 14 and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 769Postpartum and Post Abortion Diagnoses with O.R. Proceduressurgical
How is O16.5 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to O16.5. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Hypertension, hypertensive › complicating › puerperium, pre-existing (accelerated) (benign) (essential) (idiopathic) (malignant) (systemic)
Excludes1 — never code together — inherited from Chapter 15
The conditions below can never be reported together with O16.5 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 O16.5 to fully describe the condition. O16.5 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 O16.5, but a patient may have both at the same time. When documentation supports it, O16.5 and the excluded code may both be reported.
How long has O16.5 existed?
O16.5 first appears in FY2018 (FY2017 is not available, so it may have appeared then).
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.