Is ICD-10-CM code O00.12 billable?

No, O00.12 (Interstitial ectopic pregnancy without intrauterine pregnancy) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code O00.12 belong to?

O00.12 belongs to Chapter 15 of the ICD-10-CM tabular list: O00–O9A (Pregnancy, Childbirth and the Puerperium).

O00.12Non-billable

Interstitial ectopic pregnancy without intrauterine pregnancy

Pregnancy, Childbirth and the Puerperium·Tubal pregnancy·subcategory·FY 2027

3 billable codes under O00.12: all are a CC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.

Ectopic Pregnancy: The uterus, or womb, is the place where a fetus grows during pregnancy. In an ectopic pregnancy, the fertilized egg grows in the wrong place outside the uterus. It usually occurs in the fallopian tubes. These tubes carry eggs from the ovaries to the uterus. Sometimes, an ectopic pregnancy can occur in the ovaries, abdominal cavity, or the lower part of the uterus (cervix).

Read more about ectopic pregnancy on MedlinePlus · Source: MedlinePlus, National Library of Medicine

Instructional notes

Also applies, from O00.1: Tubal pregnancy

These notes sit on O00.1 and apply to every code under it, including O00.12.

Includes: conditions that are coded here

Fallopian pregnancy
Rupture of (fallopian) tube due to pregnancy
Tubal abortion

Also applies, from O00: Ectopic pregnancy

These notes sit on O00 and apply to every code under it, including O00.12.

Includes: conditions that are coded here

ruptured ectopic pregnancy

Use additional code: add a second code for this, listed after this one

code from category O08 to identify any associated complication

Also applies, from Pregnancy with abortive outcome (O00-O08)

These notes sit on O00-O08 and apply to every code under it, including O00.12.

Excludes1: not coded here, use a different code

continuing pregnancy in multiple gestation after abortion of one fetus or more (O31.1-, O31.3-)

All codes under O00.12

O00.12 can't be used on a claim. Pick a billable code below; grey headings group them.

MS-DRGs

As the principal diagnosis, all 3 billable codes under O00.12 group to these MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.