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O43

O43Placental disorders

Non-billable headerICD-10-CM

O43 is a non-billable header ICD-10-CM code for placental disorders. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes2 — not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

  • maternal care for poor fetal growth due to placental insufficiency (O36.5-)
  • placenta previa (O44.-)
  • placental polyp (O90.89)
  • placentitis (O41.14-)
  • premature separation of placenta [abruptio placentae] (O45.-)

Other codes that can never be billed with O43

These codes carry an Excludes1 note pointing at O43. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading O43 alone.

  • O36Maternal care for other fetal problems
  • O73Retained placenta and membranes, without hemorrhage

Risk adjustment

O43 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code to one of these instead O43

5 child codes. Green means billable.

Questions about O43

Is O43 a billable ICD-10-CM code?
No. O43 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does O43 sit in the tabular list?
Pregnancy, childbirth and the puerperium (O00-O9A), in the block Maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48).
ICD-10-CMFY2026-Apr· effective April 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release — see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.