Is ICD-10-CM code O94 billable?

Yes, O94 (Sequelae of complication of pregnancy, childbirth, and the puerperium) is a billable ICD-10-CM diagnosis code, valid for reimbursement on HIPAA-covered transactions for FY2027.

Is O94 exempt from POA reporting?

Yes, O94 is on the CMS list of ICD-10-CM codes exempt from Present On Admission (POA) reporting for FY2027. Inpatient claims do not require a POA indicator for this code.

What chapter does ICD-10-CM code O94 belong to?

O94 belongs to Chapter 15 of the ICD-10-CM tabular list: O00–O9A (Pregnancy, Childbirth and the Puerperium).

O94Billable, valid for claims from October 1, 2026

Sequelae of complication of pregnancy, childbirth, and the puerperium

In Other obstetric conditions, not elsewhere classified (O94-O9A), chapter 15: Pregnancy, Childbirth and the Puerperium

O94 is billable and valid on claims for FY 2027. If the record has more detail, check the other codes under O94-O9A below.
As a secondary diagnosis it is not a CC or MCC, so it doesn't raise the MS-DRG payment.
Doesn't count toward a Medicare Advantage risk score (no HCC in V28).
AHRQ's Chronic Condition Indicator classes it as not chronic (an acute or short-term condition).
Expected only on maternity records. (Maternity list)
Medicare edits don't accept it as the principal diagnosis. (Unacceptable Principal list)
Exempt from present-on-admission (POA) reporting. (POA Exempt list)

Also indexed as: Sequelae, childbirth; Sequelae, obstetrical condition; Sequelae, pregnancy; Sequelae, puerperium

Instructional notes

Code first: code the underlying condition first, then this code

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

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.p Code O94, Sequelae of complication of pregnancy, childbirth, and the puerperium (page 70), covers O94
Use O94 when a pregnancy complication leaves a sequela needing later care, at any time after the initial postpartum period. Sequence O94 after the code for the sequela itself.

Other codes under O94-O9A

Other obstetric conditions, not elsewhere classified (O94-O9A)

O94Sequelae of complication of pregnancy, childbirth, and the puerperium(this code)
O98Maternal infectious and parasitic diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium
O99Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium
O9AMaternal malignant neoplasms, traumatic injuries and abuse classifiable elsewhere but complicating pregnancy, childbirth and the puerperium

O94 MS-DRGs

As the principal diagnosis, O94 groups to MS-DRG 769 or 776 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

Related conditions

Grouped by AHRQ's Clinical Classifications Software Refined (CCSR), which sorts every diagnosis code into clinically meaningful categories.

O94 is in Other specified complications in pregnancy (PRG028), with 318 codes. Others in it:

O12.00 Gestational edema, unspecified trimester
O12.01 Gestational edema, first trimester
O12.02 Gestational edema, second trimester
O12.03 Gestational edema, third trimester
O12.10 Gestational proteinuria, unspecified trimester
O12.11 Gestational proteinuria, first trimester
O12.12 Gestational proteinuria, second trimester
O12.13 Gestational proteinuria, third trimester

Other codes that refer to O94

Notes on these codes point to O94.

Z3A Code First: obstetric condition or encounter for delivery (O09-O60, O80-O82, O94-O9A)

About the condition

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

Childbirth Problems

Childbirth is the process of giving birth to a baby. It includes labor and delivery. Usually everything goes well, but problems can happen. They may cause a risk to the mother, baby, or both. Some of the more common childbirth problems include:

Health Problems in Pregnancy

A health problem in pregnancy is any disease or condition that could affect your health or the health of your fetus. Some health problems may make it more likely that you will have a high-risk pregnancy. A high-risk pregnancy is one in which you, your fetus, or both are at higher risk for health problems than in a typical pregnancy.

Code history

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

ICD-9-CM equivalent

Legacy crosswalk from the CMS General Equivalence Mappings (last updated 2018).

677 Late effect of complication of pregnancy, childbirth, and the puerperium

ICD-9 to ICD-10 converter