Is ICD-10-CM code O11 billable?

No, O11 (Pre-existing hypertension with pre-eclampsia) 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 O11 belong to?

O11 belongs to Chapter 15 of the ICD-10-CM tabular list: O00–O9A (Pregnancy, Childbirth and the Puerperium).

O11Not billable, use a more specific code below

Pre-existing hypertension with pre-eclampsia

In Edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium (O10-O16), chapter 15: Pregnancy, Childbirth and the Puerperium

6 billable codes under O11: 3 are an MCC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.

Also indexed as: Hypertension, complicating, pregnancy, pre-existing, with, pre-eclampsia

Instructional notes

Includes: conditions that are coded here

conditions in O10 complicated by pre-eclampsia
pre-eclampsia superimposed pre-existing hypertension

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

code from O10 to identify the type of hypertension

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Section I.C.15.d Pre-existing hypertension in pregnancy (page 66), covers O11
When an O10 code for hypertensive heart disease or hypertensive chronic kidney disease is assigned, add a secondary code from the appropriate hypertension category to identify the type of heart failure or chronic kidney disease.

All codes under O11

O11 can't be used on a claim. Pick a billable code below; grey headings group them.

O11 MS-DRGs

As the principal diagnosis, the billable codes under O11 group to these 8 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 817 Other Antepartum Diagnoses with O.R. Procedures with MCC (4 of 6 codes)
DRG 818 Other Antepartum Diagnoses with O.R. Procedures with CC (4 of 6 codes)
DRG 819 Other Antepartum Diagnoses with O.R. Procedures without CC/MCC (4 of 6 codes)
DRG 831 Other Antepartum Diagnoses without O.R. Procedures with MCC (4 of 6 codes)
DRG 832 Other Antepartum Diagnoses without O.R. Procedures with CC (4 of 6 codes)
DRG 833 Other Antepartum Diagnoses without O.R. Procedures without CC/MCC (4 of 6 codes)
DRG 769 Postpartum and Post Abortion Diagnoses with O.R. Procedures (1 of 6 codes)
DRG 776 Postpartum and Post Abortion Diagnoses without O.R. Procedures (1 of 6 codes)

Other codes that refer to O11

Notes on these codes point to O11.

I10 Excludes1: hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)
I10-I1A Excludes2: hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)
O10 Excludes2: pre-existing hypertension with superimposed pre-eclampsia complicating pregnancy, childbirth and the puerperium (O11.-)
O14 Excludes1: pre-existing hypertension with pre-eclampsia (O11)
P00.0 Includes: Newborn affected by maternal conditions classifiable to O10-O11, O13-O16

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

High Blood Pressure in Pregnancy

Blood pressure is the force of your blood pushing against the walls of your arteries. Your arteries are blood vessels that carry blood from your heart to other parts of your body. High blood pressure, or hypertension, is blood pressure that is higher than normal. Having high blood pressure can put you at risk for other health problems, such as heart disease, heart attack, and stroke.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.