2026 ICD-10-CM Diagnosis Code O94Sequelae of complication of pregnancy, childbirth, and the puerperium

ICD-10-CM Codes›O00-O9A›O94-O9A›O94

ICD-10-CM O94
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

O94 is a billable ICD-10-CM diagnosis code for sequelae of complication of pregnancy, childbirth, and the puerperium. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 769, 776. The code is restricted by the Medicare Code Editor to maternity cases (age 9 through 64), not accepted as a principal diagnosis, and exempt from POA reporting. Coders also document this condition as death from sequela of indirect maternal cause. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified complications in pregnancy.

Code Identity

ICD-10-CM Code
O94
Billable Status
Yes — Valid for Submission
Code Describes
Sequelae of complication of pregnancy, childbirth, and the puerperium
Short Description
Sequelae of comp of pregnancy, chldbrth, and the puerperium
Chapter
O94-O9A
Other obstetric conditions, not elsewhere classified

Code Classification

ChapterO00-O9APregnancy, childbirth and the puerperium
SectionO94-O9AOther obstetric conditions, not elsewhere classified
CategoryO94Sequelae of complication of pregnancy, childbirth, and the puerperium
This CodeO94Sequelae of complication of pregnancy, childbirth, and the puerperium

Code EditsBilling

Medicare Code Editor checks that affect claim validity for O94.

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).
Unacceptable principal diagnosis
There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Present on Admission (POA)Billing

O94 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Other obstetric conditions, not elsewhere classified (O94-O9A).

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Death from sequela of indirect maternal cause
  • Indirect maternal death
  • Maternal death
  • Sequela of complication of pregnancy childbirth and the puerperium

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Code First

  • condition resulting from (sequela) of complication of pregnancy, childbirth, and the puerperium

  • This category is to be used to indicate conditions in O00 O77 O85 O98 O9A

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 PRG028
Other specified complications in pregnancy
Default principal diagnosis: inpatient No · outpatient Yes

Clinical InformationClinical

  • Maternal Death

    the death of the female parent.

  • Second Degree Perineal Laceration

    injury to perineum involving perineal muscles but not involving anal sphincter. (revitalize)

  • Indirect Maternal Death

    death resulting from previously existing disease or a disease developing during pregnancy which was not associated with gestation, but which was aggravated by the unique physiologic changes of pregnancy. examples of indirect deaths include those associated with epilepsy, diabetes, cardiac disease and hormone-dependent malignancies.

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 O94 to ICD-9-CMHistory

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

ICD-9-CM
677 Late effct cmplcatn preg
Exact Match The mapping is direct, with no qualifiers.

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 O94Overview

What is the ICD-10 code for sequelae of complication of pregnancy, childbirth, and the puerperium?

The ICD-10-CM code for sequelae of complication of pregnancy, childbirth, and the puerperium is O94. It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Is O94 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report sequelae of complication of pregnancy, childbirth, and the puerperium on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does O94 group to?

On inpatient claims, sequelae of complication of pregnancy, childbirth, and the puerperium maps to MS-DRG 769, 776, with relative weights from 0.6547 to 1.6898 depending on complications. Higher weights mean higher Medicare reimbursement.

Can O94 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because sequelae of complication of pregnancy, childbirth, and the puerperium describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Who can O94 be reported for?

The Medicare Code Editor checks sequelae of complication of pregnancy, childbirth, and the puerperium against patient demographics: this code is intended for maternity cases (age 9 through 64). Claims outside these limits are flagged as inconsistent.