Is O99.111 a billable ICD-10-CM code?

Yes. O99.111 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does O99.111 sit in the tabular list?

Pregnancy, childbirth and the puerperium (O00-O9A), in the block Other obstetric conditions, not elsewhere classified (O94-O9A).

What cannot be coded together with O99.111?

O99.111 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 O99.111 (O99.1) and apply to it just the same.

O99.111

O99.111 — Other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism complicating pregnancy, first trimester

Billable / specific codeICD-10-CM

O99.111 is a billable, specific ICD-10-CM code for other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism complicating pregnancy, first trimester. It is valid for submission on a claim.

Excludes1 inherited from the categories above O99.111

These are not written on O99.111, but they bind it: a note on a category applies to every code beneath it. Billing O99.111 with anything listed here is a denial.

Written on O99.1 — Other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism complicating pregnancy, childbirth and the puerperium

hemorrhage with coagulation defects (O45.-, O46.0-, O67.0, O72.3)

Excludes2 inherited from the categories above O99.111

Also inherited, and the opposite of Excludes1: these conditions are not part of O99.111, but a patient can have both, so you may code both.

Written on O99 — Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium

when the reason for maternal care is that the condition is known or suspected to have affected the fetus (O35-O36)

Risk adjustment

O99.111 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

O99.111 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share O99.11. If O99.111 is not quite right, the correct code is usually one of these.

Questions about O99.111

Is O99.111 a billable ICD-10-CM code?: Yes. O99.111 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does O99.111 sit in the tabular list?: Pregnancy, childbirth and the puerperium (O00-O9A), in the block Other obstetric conditions, not elsewhere classified (O94-O9A).
What cannot be coded together with O99.111?: O99.111 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 O99.111 (O99.1) and apply to it just the same.