Is ICD-10-CM code O42 billable?

No, O42 (Premature rupture of membranes) 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 O42 belong to?

O42 belongs to Chapter 15 of the ICD-10-CM tabular list: O00–O9A (Pregnancy, Childbirth and the Puerperium).

O42Non-billable

Premature rupture of membranes

Pregnancy, Childbirth and the Puerperium·Maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)·category·FY 2026

Use a more specific code (0 billable, 3 non-billable)

O42.0Premature rupture of membranes, onset of labor within 24 hours of rupturehas subcodes O42.1Premature rupture of membranes, onset of labor more than 24 hours following rupturehas subcodes O42.9Premature rupture of membranes, unspecified as to length of time between rupture and onset of laborhas subcodes

CH15 Parent Instructions

Excludes1(Not coded here. Use a different code.)

supervision of normal pregnancy (Z34.-)

Excludes2(Not included here. Code separately if applicable.)

mental and behavioral disorders associated with the puerperium (F53.-)
obstetrical tetanus (A34)
postpartum necrosis of pituitary gland (E23.0)
puerperal osteomalacia (M83.0)

Use Additional Code

code, if applicable, from category Z3A, Weeks of gestation, to identify the specific week of the pregnancy, if known.

Clinical Hierarchy

BillableHas subcodes

CH15Pregnancy, childbirth and the puerperium (O00-O9A)

O30-O48Maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)

O42Premature rupture of membranesNot billable

O42.0Premature rupture of membranes, onset of labor within 24 hours of ruptureSubcodes

O42.1Premature rupture of membranes, onset of labor more than 24 hours following ruptureSubcodes

O42.9Premature rupture of membranes, unspecified as to length of time between rupture and onset of laborSubcodes

MS-DRG Classification

2026

No direct MS-DRG triggers identified.