Is O9A.4 a billable ICD-10-CM code?

No. O9A.4 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does O9A.4 sit in the tabular list?

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

O9A.4

O9A.4 — Sexual abuse complicating pregnancy, childbirth and the puerperium

Non-billable headerICD-10-CM

O9A.4 is a non-billable header ICD-10-CM code for sexual abuse complicating pregnancy, childbirth and the puerperium. It cannot be billed on its own: choose one of the more specific child codes below.

Use additional code

Add a secondary code to capture the detail described below.

code (if applicable):
to identify any associated current injury due to sexual abuse
to identify the perpetrator of abuse (Y07.-)

Inclusion terms

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

Conditions in T74.21 or T76.21

Other codes that can never be billed with O9A.4

These codes carry an Excludes1 note pointing at O9A.4. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading O9A.4 alone.

T74Adult and child abuse, neglect and other maltreatment, confirmed
T76Adult and child abuse, neglect and other maltreatment, suspected

Risk adjustment

O9A.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.

Code to one of these instead O9A.4

3 child codes. Green means billable.

Related codes at this level

Codes that share O9A. If O9A.4 is not quite right, the correct code is usually one of these.

Questions about O9A.4

Is O9A.4 a billable ICD-10-CM code?: No. O9A.4 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does O9A.4 sit in the tabular list?: Pregnancy, childbirth and the puerperium (O00-O9A), in the block Other obstetric conditions, not elsewhere classified (O94-O9A).