O94

Sequelae of complication of pregnancy, childbirth, and the puerperium

FY2027Chapter 15: Pregnancy, childbirth and the puerperium/O94–O9A Other obstetric conditions, not elsewhere classified

BillableComplete code, valid to report

O94 is a billable ICD-10-CM diagnosis code for sequelae of complication of pregnancy, childbirth, and the puerperium. It is part of the FY2027 code set, effective October 1, 2026. The Alphabetic Index lists it under 4 entries. Its coding notes include a Code first instruction, a Use additional code instruction, 1 Excludes1 entry and 4 Excludes2 entries.

Guidelines tips

From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.

The trimester character comes from the provider's documentation for the current encounter. The unspecified trimester code should rarely be used.

Guidelines I.C.15.a.3; I.C.15.a.5Pregnancy: the trimester characterRead the official text

O94 can be used any time after the initial postpartum period and is sequenced after the code describing the sequela.

Guidelines I.C.15.pSequelae of pregnancy complications (O94)Read the official text

Code first

If the underlying condition listed here is present and known, sequence it first.

This code
  • condition resulting from (sequela) of complication of pregnancy, childbirth, and the puerperium

Use additional code

Add the listed code as a secondary code, if known.

Also from chapter/block level (1 note)
Inherited from Chapter 15 Pregnancy, childbirth and the puerperium
  • code, if applicable, from category Z3A, Weeks of gestation, to identify the specific week of the pregnancy, if known.

Excludes1

Not coded here. The listed conditions generally should not be reported together.

Also from chapter/block level (1 note)
Inherited from Chapter 15 Pregnancy, childbirth and the puerperium
  • supervision of normal pregnancy (Z34.-)

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

Also from chapter/block level (4 notes)
Inherited from Chapter 15 Pregnancy, childbirth and the puerperium
  • mental and behavioral disorders associated with the puerperium (F53.-)
  • obstetrical tetanus (A34)
  • postpartum necrosis of pituitary gland (E23.0)
  • puerperal osteomalacia (M83.0)

Care settings

How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.

Hospice: not accepted as primary

Not accepted as the principal diagnosis on a hospice claim (bill types 081x and 082x). The Integrated OCE returns an edit for this code.
Reason: Supplementary or additional code, not allowed as principal diagnosis.

Source: CMS Integrated Outpatient Code Editor (IOCE) v27.3, effective October 1, 2026, edit 113

Notes

This code
  • 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
Also from chapter/block level (6 notes)
Inherited from Chapter 15 Pregnancy, childbirth and the puerperium
  • 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

Alphabetic Index terms

Terms the official Alphabetic Index lists for this code. 4 entries