2027 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 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

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 2027 (October 1, 2026 through September 30, 2027) 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

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to O94: 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.

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 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)

Code First

The underlying condition named in the note is sequenced before this code.

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

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.

On O94 itself
  • This category is to be used to indicate conditions in O00-O77.-, O85-O94 and O98-O9A.- as the cause of late effects. The sequelae include conditions specified as such, or as late effects, which may occur at any time after the puerperium
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.

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

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 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

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, 2026 through September 30, 2027.

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, 2026 through September 30, 2027.

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 0.6718 to 1.6666 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.