O94 — Sequelae of complication of pregnancy, childbirth, and the puerperium
Is O94 billable?
Yes — O94 is billable for FY2027. O94 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. O94 may be submitted for encounters from October 1, 2026 through September 30, 2027.
O94 at a glance
| Code | O94 |
|---|---|
| Description | Sequelae of complication of pregnancy, childbirth, and the puerperium |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to O94?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name O94 directly.
CMS will reject this code as the principal diagnosis on an inpatient claim. It describes something other than the condition chiefly responsible for the admission.
Which MS-DRGs does O94 group to?
O94 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 O94 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to O94. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Sequelae › childbirth (of)
- Sequelae › obstetrical condition (of)
- Sequelae › pregnancy (of)
- Sequelae › puerperium (of)
Code first
The underlying condition below must be sequenced before O94. O94 describes a manifestation and cannot be the principal or first-listed diagnosis.
- condition resulting from (sequela) of complication of pregnancy, childbirth, and the puerperium
Note
Excludes1 — never code together — inherited from Chapter 15
The conditions below can never be reported together with O94 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 O94 to fully describe the condition. O94 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 O94, but a patient may have both at the same time. When documentation supports it, O94 and the excluded code may both be reported.
How long has O94 existed?
O94 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.