Is O75.4 a billable ICD-10-CM code?

Yes. O75.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does O75.4 sit in the tabular list?

Pregnancy, childbirth and the puerperium (O00-O9A), in the block Complications of labor and delivery (O60-O77).

O75.4

O75.4 — Other complications of obstetric surgery and procedures

Billable / specific codeICD-10-CM

O75.4 is a billable, specific ICD-10-CM code for other complications of obstetric surgery and procedures. It is valid for submission on a claim.

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.

complications of anesthesia during labor and delivery (O74.-)
disruption of obstetrical (surgical) wound (O90.0-O90.1)
hematoma of obstetrical (surgical) wound (O90.2)
infection of obstetrical (surgical) wound (O86.0-)

Use additional code

Add a secondary code to capture the detail described below.

code to identify specific complication

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Cardiac arrest following obstetric surgery or procedures
Cardiac failure following obstetric surgery or procedures
Cerebral anoxia following obstetric surgery or procedures
Pulmonary edema following obstetric surgery or procedures

Risk adjustment

O75.4 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.

Medicare coverage

O75.4 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A57189Billing and Coding: Serum Magnesium
A57326Billing and Coding: Electrocardiograms

How O75.4 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to O75.4.

Complication›delivery›procedure(instrumental) (manual) (surgical)
Complication›obstetric›procedure specified NEC(instrumental) (manual) (surgical)
Anoxia›cerebral›complicating›delivery(cesarean) (instrumental)
Arrest, arrested›cardiac›complicating›delivery(cesarean) (instrumental)
Arrest, arrested›cardiac›postprocedural›obstetric procedure
Failure, failed›heart›complicating›delivery(cesarean) (instrumental)

Related codes at this level

Codes that share O75. If O75.4 is not quite right, the correct code is usually one of these.

Questions about O75.4

Is O75.4 a billable ICD-10-CM code?: Yes. O75.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does O75.4 sit in the tabular list?: Pregnancy, childbirth and the puerperium (O00-O9A), in the block Complications of labor and delivery (O60-O77).