2027 ICD-10-CM Diagnosis Code O12.25Gestational edema with proteinuria, complicating the puerperium
ICD-10-CM Codes›O00-O9A›O10-O16›O12
- Billable — Valid for Submission
- Not Chronic
O12.25 is a billable ICD-10-CM diagnosis code for gestational edema with proteinuria, complicating the puerperium. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 769, 776. The code is restricted by the Medicare Code Editor to maternity cases (age 9 through 64). Coders also document this condition as gestational edema. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Complications specified during the puerperium and Proteinuria.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for O12.25.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Gestational edema
- Gestational edema with proteinuria
- Gestational edema with proteinuria during maternal postpartum period
- Gestational proteinuria
- Postpartum edema
- Postpartum gestational proteinuria
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to O12.25: its own notes plus those printed at Chapter 15. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
- supervision of normal pregnancy (Z34.-)
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code, if applicable, from category Z3A, Weeks of gestation, to identify the specific week of the pregnancy, if known.
Notes
General instructions on how these codes are used.
- CODES FROM THIS CHAPTER ARE FOR USE ONLY ON MATERNAL RECORDS, NEVER ON NEWBORN RECORDS
- Codes from this chapter are for use for conditions related to or aggravated by the pregnancy, childbirth, or by the puerperium (maternal causes or obstetric causes)
- Trimesters are counted from the first day of the last menstrual period. They are defined as follows:
- 1st trimester- less than 14 weeks 0 days
- 2nd trimester- 14 weeks 0 days to less than 28 weeks 0 days
- 3rd trimester- 28 weeks 0 days until delivery
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name O12.25, its category, or a range that includes it.
Excludes2 2
These codes carry an Excludes2 note naming O12.25: its condition is not part of those codes, and both may be reported when the patient has both.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Childbirth Problems
Childbirth is the process of giving birth to a baby. It includes labor and delivery. Usually everything goes well, but problems can happen. They may cause a risk to the mother, baby, or both. Some of the more common childbirth problems include:
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert O12.25 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code History & ChangesHistory
Replacement O12.25 replaces the following previously assigned code(s):
- O12.20 - Gestational edema with proteinuria, unspecified trimester
Questions About O12.25Overview
What is the ICD-10 code for gestational edema with proteinuria, complicating the puerperium?
The ICD-10-CM code for gestational edema with proteinuria, complicating the puerperium is O12.25 (sometimes written as O1225). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is O12.25 (Gestational edema with proteinuria) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report gestational edema with proteinuria, complicating the puerperium on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does O12.25 group to?
When gestational edema with proteinuria, complicating the puerperium is the principal diagnosis on an inpatient stay, it groups to MS-DRG 769, 776, with relative weights from 0.6718 to 1.6666 depending on complications. Higher weights mean higher Medicare reimbursement.
Who can O12.25 be reported for?
The Medicare Code Editor checks gestational edema with proteinuria, complicating the puerperium 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 O12.25?
Under the General Equivalence Mappings, gestational edema with proteinuria, complicating the puerperium converts to ICD-9-CM 646.14 (edema in preg-postpartum), 646.14 (edema in preg-postpartum), and 646.24 (renal dis NOS-postpartum). The mapping is approximate, so confirm the match fits the documentation.
