2026 ICD-10-CM Diagnosis Code O12.04Gestational edema, complicating childbirth

ICD-10-CM Codes›O00-O9A›O10-O16›O12

ICD-10-CM O12.04
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

O12.04 is a billable ICD-10-CM diagnosis code for gestational edema, complicating childbirth. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). The code is restricted by the Medicare Code Editor to maternity cases (age 9 through 64). In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Complications specified during childbirth.

Code Identity

ICD-10-CM Code
O12.04
Billable Status
Yes — Valid for Submission
Code Describes
Gestational edema, complicating childbirth
Short Description
Gestational edema, complicating childbirth
Same as the full description in the CMS dataset.
Parent Code
O12.0
Gestational edema

Code Classification

ChapterO00-O9APregnancy, childbirth and the puerperium
SectionO10-O16Edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium
CategoryO12Gestational [pregnancy-induced] edema and proteinuria without hypertension
This CodeO12.04Gestational edema, complicating childbirth

Code EditsBilling

Medicare Code Editor checks that affect claim validity for O12.04.

Maternity diagnoses
The Medicare Code Editor detects inconsistencies in maternity cases by checking a patient's age and any diagnosis on the patient's record. The maternity code edits apply to patients age ange is 9–64 years inclusive (e.g., diabetes in pregnancy, antepartum pulmonary complication).

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Delivery(childbirth) (labor)
      • complicated
        • by
          • gestational
            • edema

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR PRG023
Complications specified during childbirth
Default principal diagnosis: inpatient Yes · outpatient Yes

Convert O12.04 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
646.11 Edema in preg-delivered
Approximate The match is approximate rather than exact.

Code History & ChangesHistory

Replacement O12.04 replaces the following previously assigned code(s):

  • O12.00 - Gestational edema, unspecified trimester
FY 2018AddedAdded to the ICD-10-CM code setEffective October 1, 2017.
FY 2019–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About O12.04Overview

Is O12.04 (Gestational edema) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report gestational edema, complicating childbirth on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Who can O12.04 be reported for?

The Medicare Code Editor checks gestational edema, complicating childbirth against patient demographics: this code is intended for maternity cases (age 9 through 64). Claims outside these limits are flagged as inconsistent.

What is the ICD-9 equivalent of O12.04?

Under the General Equivalence Mappings, gestational edema, complicating childbirth converts to ICD-9-CM 646.11 (edema in preg-delivered). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.