2026 ICD-10-CM Diagnosis Code O43.111Circumvallate placenta, first trimester

ICD-10-CM Codes›O00-O9A›O30-O48›O43

ICD-10-CM O43.111
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

O43.111 is a billable ICD-10-CM diagnosis code for circumvallate placenta, first trimester. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) 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). In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Maternal care related to disorders of the placenta and placental implantation.

Code Identity

ICD-10-CM Code
O43.111
Billable Status
Yes — Valid for Submission
Code Describes
Circumvallate placenta, first trimester
Short Description
Circumvallate placenta, first trimester
Same as the full description in the CMS dataset.
Parent Code
O43.11
Circumvallate placenta

Code Classification

ChapterO00-O9APregnancy, childbirth and the puerperium
SectionO30-O48Maternal care related to the fetus and amniotic cavity and possible delivery problems
CategoryO43Placental disorders
This CodeO43.111Circumvallate placenta, first trimester

Code EditsBilling

Medicare Code Editor checks that affect claim validity for O43.111.

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).

Clinical ClassificationClinical

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

CCSR PRG018
Maternal care related to disorders of the placenta and placental implantation
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Health Problems in Pregnancy

A health problem in pregnancy is any disease or condition that could affect your health or the health of your fetus. Some health problems may make it more likely that you will have a high-risk pregnancy. A high-risk pregnancy is one in which you, your fetus, or both are at higher risk for health problems than in a typical pregnancy.

The full article covers:

  • What are health problems in pregnancy?
  • What raises my risk for health problems during pregnancy?
  • Can chronic health conditions cause problems in pregnancy?
  • Can health problems in pregnancy be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert O43.111 to ICD-9-CMHistory

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

ICD-9-CM
656.71 Oth placent cond-deliver
Approximate The match is approximate rather than exact.
ICD-9-CM
656.73 Oth placent cond-antepar
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About O43.111Overview

Is O43.111 (Circumvallate placenta) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report circumvallate placenta, first trimester on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does O43.111 group to?

When circumvallate placenta, first trimester is the principal diagnosis on an inpatient stay, it groups to MS-DRG 817, 818, 819, 831, 832, 833, with relative weights from 0.5229 to 1.6880 depending on complications. Higher weights mean higher Medicare reimbursement.

Who can O43.111 be reported for?

The Medicare Code Editor checks circumvallate placenta, first trimester 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 O43.111?

Under the General Equivalence Mappings, circumvallate placenta, first trimester converts to ICD-9-CM 656.71 (oth placent cond-deliver) and 656.73 (oth placent cond-antepar). 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.