2027 ICD-10-CM Diagnosis Code O42.00Premature rupture of membranes, onset of labor within 24 hours of rupture, unspecified weeks of gestation
ICD-10-CM Codes›O00-O9A›O30-O48›O42
- Billable — Valid for Submission
- Not Chronic
O42.00 is a billable ICD-10-CM diagnosis code for premature rupture of membranes, onset of labor within 24 hours of rupture, unspecified weeks of gestation. 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. The code is restricted by the Medicare Code Editor to maternity cases (age 9 through 64). Coders also document this condition as prem rupture of membranes onset of labor within 24 hours. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Early or threatened labor.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for O42.00.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Prem rupture of membranes onset of labor within 24 hours
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to O42.00: 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.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Pregnancy (single) (uterine) See Also: Delivery and Puerperal; Z33.1
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Premature Rupture of Membrane
spontaneous rupture of fetal membranes that occurs before the onset of labor. if rupture occurs before 37 weeks of gestation then the correct diagnosis is preterm premature rupture of membranes.
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 O42.00 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About O42.00Overview
Is O42.00 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report premature rupture of membranes, onset of labor within 24 hours of rupture, unspecified weeks of gestation on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does O42.00 group to?
When premature rupture of membranes, onset of labor within 24 hours of rupture, unspecified weeks of gestation 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.
Who can O42.00 be reported for?
The Medicare Code Editor checks premature rupture of membranes, onset of labor within 24 hours of rupture, unspecified weeks of gestation 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 O42.00?
Under the General Equivalence Mappings, premature rupture of membranes, onset of labor within 24 hours of rupture, unspecified weeks of gestation converts to ICD-9-CM 658.10 (prem rupt membran-unspec). The mapping is approximate, so confirm the match fits the documentation.