2027 ICD-10-CM Diagnosis Code O26.641Intrahepatic cholestasis of pregnancy, first trimester
ICD-10-CM Codes›O00-O9A›O20-O29›O26
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Not Chronic
O26.641 is a billable ICD-10-CM diagnosis code for intrahepatic cholestasis of pregnancy, first trimester. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 817 through 819, 831 through 833. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 226 closely related codes. 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 Other specified and unspecified liver disease and Other specified complications in pregnancy.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for O26.641.
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to O26.641: its own notes plus those printed at O26.64, O26.6, block O20-O29, and 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.
- hepatorenal syndrome following labor and delivery (O90.41)
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code for hepatic obstruction (K76.89)
- code to identify the specific disorder
- 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 O26.641, its category, or a range that includes it.
Excludes1 1
These codes carry an Excludes1 note naming O26.641: they are not reported together with it, unless the two conditions are unrelated.
Excludes2 2
These codes carry an Excludes2 note naming O26.641: its condition is not part of those codes, and both may be reported when the patient has both.
- K72 Hepatic failure, not elsewhere classifiedhepatic failure complicating pregnancy, childbirth and the puerperium (O26.6-) names O26.6-, which includes this code
- O99.6 Diseases of the digestive system complicating pregnancy, childbirth and the puerperiumliver and biliary tract disorders in pregnancy, childbirth and the puerperium (O26.6-) names O26.6-, which includes this code
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Bile Duct Diseases
Your liver makes a digestive juice called bile. Your gallbladder stores it between meals. When you eat, your gallbladder pushes the bile into tubes called bile ducts. They carry the bile to your small intestine. The bile helps break down fat. It also helps the liver get rid of toxins and wastes.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Code History & ChangesHistory
Replacement O26.641 replaces the following previously assigned code(s):
- O26.611 - Liver and biliary tract disord in pregnancy, first trimester
Questions About O26.641Overview
What is the ICD-10 code for intrahepatic cholestasis of pregnancy, first trimester?
The ICD-10-CM code for intrahepatic cholestasis of pregnancy, first trimester is O26.641 (sometimes written as O26641). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is O26.641 (Intrahepatic cholestasis of pregnancy) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report intrahepatic cholestasis of pregnancy, first trimester on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does O26.641 group to?
When intrahepatic cholestasis of pregnancy, first trimester is the principal diagnosis on an inpatient stay, it groups to MS-DRG 833, 832, 831, 819, 818, 817, with relative weights from 0.5000 to 1.7586 depending on complications. Higher weights mean higher Medicare reimbursement.
Is O26.641 a CC or MCC?
CMS lists O26.641 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 226 closely related codes in its exclusion list.
Who can O26.641 be reported for?
The Medicare Code Editor checks intrahepatic cholestasis of pregnancy, first trimester against patient demographics: this code is intended for maternity cases (age 9 through 64). Claims outside these limits are flagged as inconsistent.
