O42.019 — Preterm premature rupture of membranes, onset of labor within 24 hours of rupture, unspecified trimester
Is O42.019 billable?
Yes, but O42.019 is an unspecified code. O42.019 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, O42.019 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 O42.019 — the more specific alternatives are listed below.
More specific alternatives
- O42.011Preterm premature rupture of membranes, onset of labor within 24 hours of rupture, first trimester
- O42.012Preterm premature rupture of membranes, onset of labor within 24 hours of rupture, second trimester
- O42.013Preterm premature rupture of membranes, onset of labor within 24 hours of rupture, third trimester
O42.019 at a glance
| Code | O42.019 |
|---|---|
| Description | Preterm premature rupture of membranes, onset of labor within 24 hours of rupture, unspecified trimester |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does O42.019 group to?
O42.019 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 O42.019 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under O42.01, the nearest indexed parent of O42.019. Use them to find the family, then select the specific code.
- Pregnancy › complicated by › premature rupture of membranes › with onset of labor › within 24 hours › pre-term (single) (uterine)
Excludes1 — never code together — inherited from Chapter 15
The conditions below can never be reported together with O42.019 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 O42.019 to fully describe the condition. O42.019 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 O42.019, but a patient may have both at the same time. When documentation supports it, O42.019 and the excluded code may both be reported.
How long has O42.019 existed?
O42.019 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.
What other codes are in the O42.01 family? (3)
- O42.011Preterm premature rupture of membranes, onset of labor within 24 hours of rupture, first trimester
- O42.012Preterm premature rupture of membranes, onset of labor within 24 hours of rupture, second trimester
- O42.013Preterm premature rupture of membranes, onset of labor within 24 hours of rupture, third trimester