Valid for Submission
O42.913 is a billable code used to specify a medical diagnosis of preterm premature rupture of membranes, unspecified as to length of time between rupture and onset of labor, third trimester. The code is valid for the year 2020 for the submission of HIPAA-covered transactions.
The code O42.913 is applicable to female patients aged 12 through 55 years inclusive. It is clinically and virtually impossible to use this code on a non-female patient outside the stated age range.
|Short Description:||Pretrm prem ROM, unsp time betw rupt and onst labr, 3rd tri|
|Long Description:||Preterm premature rupture of membranes, unspecified as to length of time between rupture and onset of labor, third trimester|
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:
- Maternity diagnoses - Maternity. Age range is 12–55 years inclusive (e.g., diabetes in pregnancy, antepartum pulmonary complication).
- Diagnoses for females only - Medicare Code Editor detects inconsistencies between a patient’s sex and any diagnosis on the patient’s record, this code applies to FEMALES only
Diagnostic Related Groups
The ICD-10 code O42.913 is grouped in the following groups for version MS-DRG V37.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). applicable from 10/01/2019 through 09/30/2020.
- 817 - OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURE WITH MCC
- 818 - OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURE WITH CC
- 819 - OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURE WITHOUT CC/MCC
Convert O42.913 to ICD-9
- 658.11 - Prem rupt membran-deliv (Approximate Flag)
- 658.13 - Prem rupt memb-antepart (Approximate Flag)
Pregnancy, childbirth and the puerperium (O00–O99)
Maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)
Premature rupture of membranes (O42)
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
(First year ICD-10-CM implemented into the HIPAA code set)
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020