2027 ICD-10-CM Diagnosis Code O90.41Hepatorenal syndrome following labor and delivery
ICD-10-CM Codes›O00-O9A›O85-O92›O90
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Not Chronic
O90.41 is a billable ICD-10-CM diagnosis code for hepatorenal syndrome following labor and delivery. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 769, 776. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 222 closely related codes. The code is restricted by the Medicare Code Editor to maternity cases (age 9 through 64). Coders also document this condition as hepatorenal syndrome. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Acute and unspecified renal failure, Complications specified during the puerperium, and Other specified and unspecified liver disease.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for O90.41.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Hepatorenal syndrome
- Hepatorenal syndrome following delivery
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to O90.41: its own notes plus those printed at O90.4, block O85-O92, 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.
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 O90.41, its category, or a range that includes it.
Excludes1 1
These codes carry an Excludes1 note naming O90.41: they are not reported together with it, unless the two conditions are unrelated.
- K76.7 Hepatorenal syndromehepatorenal syndrome following labor and delivery (O90.41)
Excludes2 3
These codes carry an Excludes2 note naming O90.41: its condition is not part of those codes, and both may be reported when the patient has both.
- Block N17-N19 Acute kidney failure and chronic kidney diseasepostpartum hepatorenal syndrome (O90.41)
- Block N17-N19 Acute kidney failure and chronic kidney diseaserenal failure following labor and delivery (O90.41)
- O26.6 Liver and biliary tract disorders in pregnancy, childbirth and the puerperiumhepatorenal syndrome following labor and delivery (O90.41)
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Syndrome See Also: Disease;
following delivery O90.41
postpartum, puerperal O90.41
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Kidney Failure
Healthy kidneys clean your blood by removing excess fluid, minerals, and wastes. They also make hormones that keep your bones strong and your blood healthy. But if the kidneys are damaged, they don't work properly. Harmful wastes can build up in your body. Your blood pressure may rise.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Code History & ChangesHistory
Replacement O90.41 replaces the following previously assigned code(s):
- O90.4 - Postpartum acute kidney failure
Questions About O90.41Overview
What is the ICD-10 code for hepatorenal syndrome following labor and delivery?
The ICD-10-CM code for hepatorenal syndrome following labor and delivery is O90.41 (sometimes written as O9041). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is O90.41 (Postpartum acute kidney failure) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report hepatorenal syndrome following labor and delivery on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does O90.41 group to?
When hepatorenal syndrome following labor and delivery 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.
Is O90.41 a CC or MCC?
CMS lists O90.41 as an MCC (major complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 222 closely related codes in its exclusion list.
Who can O90.41 be reported for?
The Medicare Code Editor checks hepatorenal syndrome following labor and delivery against patient demographics: this code is intended for maternity cases (age 9 through 64). Claims outside these limits are flagged as inconsistent.
