2027 ICD-10-CM Diagnosis Code O90.49Other postpartum acute kidney failure

ICD-10-CM Codes›O00-O9A›O85-O92›O90

ICD-10-CM O90.49
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

O90.49 is a billable ICD-10-CM diagnosis code for other postpartum acute kidney failure. 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 postpartum acute renal failure. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Acute and unspecified renal failure and Complications specified during the puerperium.

Code Identity

ICD-10-CM Code
O90.49
Billable Status
Yes — Valid for Submission
Code Describes
Other postpartum acute kidney failure
Short Description
Other postpartum acute kidney failure
Same as the full description in the CMS dataset.
Parent Code
O90.4
Postpartum acute kidney failure

Code Classification

ChapterO00-O9APregnancy, childbirth and the puerperium
SectionO85-O92Complications predominantly related to the puerperium
CategoryO90Complications of the puerperium, not elsewhere classified
This CodeO90.49Other postpartum acute kidney failure

Code EditsBilling

Medicare Code Editor checks that affect claim validity for O90.49.

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).

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Postpartum acute renal failure

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to O90.49: 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.

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

  • Postpartum acute kidney failure
  • Puerperal anuria
  • Puerperal oliguria

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From O90.4 Postpartum acute kidney failure applies to 2 codes
  • anuria and oliguria (R34)
From Chapter 15 (O00-O9A) Pregnancy, childbirth and the puerperium applies to 2,481 codes
  • 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.

From Block O85-O92 Complications predominantly related to the puerperium applies to 114 codes
  • mental and behavioral disorders associated with the puerperium (F53.-)
  • obstetrical tetanus (A34)
  • puerperal osteomalacia (M83.0)
From Chapter 15 (O00-O9A) Pregnancy, childbirth and the puerperium applies to 2,481 codes
  • mental and behavioral disorders associated with the puerperium (F53.-)
  • obstetrical tetanus (A34)
  • postpartum necrosis of pituitary gland (E23.0)
  • puerperal osteomalacia (M83.0)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From Chapter 15 (O00-O9A) Pregnancy, childbirth and the puerperium applies to 2,481 codes
  • 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.

From Chapter 15 (O00-O9A) Pregnancy, childbirth and the puerperium applies to 2,481 codes
  • 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 O90.49, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming O90.49: they are not reported together with it, unless the two conditions are unrelated.

  • R34 Anuria and oliguria
    anuria and oliguria complicating the puerperium (O90.49)

Excludes2 1

These codes carry an Excludes2 note naming O90.49: its condition is not part of those codes, and both may be reported when the patient has both.

  • O99.8 Other specified diseases and conditions complicating pregnancy, childbirth and the puerperium
    postpartum acute kidney failure (O90.49)

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

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

CCSR GEN002
Acute and unspecified renal failure
Default principal diagnosis: inpatient No · outpatient No
CCSR PRG027
Complications specified during the puerperium
Default principal diagnosis: inpatient Yes · outpatient Yes

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 O90.49 replaces the following previously assigned code(s):

  • O90.4 - Postpartum acute kidney failure
FY 2024AddedAdded to the ICD-10-CM code setEffective October 1, 2023.
FY 2025–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About O90.49Overview

What is the ICD-10 code for other postpartum acute kidney failure?

The ICD-10-CM code for other postpartum acute kidney failure is O90.49 (sometimes written as O9049). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is O90.49 (Postpartum acute kidney failure) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report other postpartum acute kidney failure on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does O90.49 group to?

When other postpartum acute kidney failure 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 O90.49 a CC or MCC?

CMS lists O90.49 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 O90.49 be reported for?

The Medicare Code Editor checks other postpartum acute kidney failure against patient demographics: this code is intended for maternity cases (age 9 through 64). Claims outside these limits are flagged as inconsistent.