Is O43.21 a billable ICD-10-CM code?

No. O43.21 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does O43.21 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).

What cannot be coded together with O43.21?

O43.21 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above O43.21 (O43.2) and apply to it just the same.

O43.21

O43.21 — Placenta accreta

Non-billable headerICD-10-CM

O43.21 is a non-billable header ICD-10-CM code for placenta accreta. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 inherited from the categories above O43.21

These are not written on O43.21, but they bind it: a note on a category applies to every code beneath it. Billing O43.21 with anything listed here is a denial.

Written on O43.2 — Morbidly adherent placenta

retained placenta (O73.-)

Excludes2 inherited from the categories above O43.21

Also inherited, and the opposite of Excludes1: these conditions are not part of O43.21, but a patient can have both, so you may code both.

Written on O43 — Placental disorders

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 O43.21

These codes carry an Excludes1 note pointing at O43.21. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading O43.21 alone.

O73Retained placenta and membranes, without hemorrhage

Risk adjustment

O43.21 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 history

O43.21 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead O43.21

4 child codes. Green means billable.

Related codes at this level

Codes that share O43.2. If O43.21 is not quite right, the correct code is usually one of these.

Questions about O43.21

Is O43.21 a billable ICD-10-CM code?: No. O43.21 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does O43.21 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).
What cannot be coded together with O43.21?: O43.21 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above O43.21 (O43.2) and apply to it just the same.