Version 2024

2024 ICD-10-CM Diagnosis Code O9A.4

Sexual abuse complicating pregnancy, childbirth and the puerperium

ICD-10-CM Code:
O9A.4
ICD-10 Code for:
Sexual abuse compl preg/chldbrth
Is Billable?
Not Valid for Submission
Code Navigator:

Code Classification

  • Pregnancy, childbirth and the puerperium
    (O00-O9A)
    • Other obstetric conditions, not elsewhere classified
      (O94-O9A)
      • Maternal malignant neoplasms, traumatic injuries and abuse classifiable elsewhere but complicating pregnancy, childbirth and the puerperium
        (O9A)

O9A.4 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of sexual abuse complicating pregnancy, childbirth and the puerperium. The code is not specific and is NOT valid for the year 2024 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

Specific Coding Applicable to Sexual abuse compl preg/chldbrth

Non-specific codes like O9A.4 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for sexual abuse compl preg/chldbrth:

  • O9A.41 for Sexual abuse complicating pregnancy - NON-BILLABLE CODE

  • Use O9A.411 for Sexual abuse complicating pregnancy, first trimester - BILLABLE CODE

  • Use O9A.412 for Sexual abuse complicating pregnancy, second trimester - BILLABLE CODE

  • Use O9A.413 for Sexual abuse complicating pregnancy, third trimester - BILLABLE CODE

  • Use O9A.419 for Sexual abuse complicating pregnancy, unspecified trimester - BILLABLE CODE

  • Use O9A.42 for Sexual abuse complicating childbirth - BILLABLE CODE

  • Use O9A.43 for Sexual abuse complicating the puerperium - BILLABLE CODE

Tabular List of Diseases and Injuries

The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.


Inclusion Terms

Inclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.

Use Additional Code

Use Additional Code
The “use additional code” indicates that a secondary code could be used to further specify the patient’s condition. This note is not mandatory and is only used if enough information is available to assign an additional code.
  • code (if applicable):
  • to identify any associated current injury due to sexual abuse
  • to identify the perpetrator of abuse Y07

Patient Education


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:

  • Preterm (premature) labor, when your labor starts before 37 completed weeks of pregnancy
  • Premature rupture of membranes (PROM), when your water breaks too early. If labor does not start soon afterwards, this can raise the risk of infection.
  • Problems with the placenta, such as the placenta covering the cervix, separating from the uterus before birth, or being attached too firmly to the uterus
  • Labor that does not progress, meaning that labor is stalled. This can happen when
    • Your contractions weaken
    • Your cervix does not dilate (open) enough or is taking too long to dilate
    • The baby is not in the right position
    • The baby is too big or your pelvis is too small for the baby to move through the birth canal
  • Abnormal heart rate of the baby. Often, an abnormal heart rate is not a problem. But if the heart rate gets very fast or very slow, it can be a sign that your baby is not getting enough oxygen or that there are other problems.
  • Problems with the umbilical cord, such as the cord getting caught on the baby's arm, leg, or neck. It's also a problem if cord comes out before the baby does.
  • Problems with the position of the baby, such as breech, in which the baby is going to come out feet first
  • Shoulder dystocia, when the baby's head comes out, but the shoulder gets stuck
  • Perinatal asphyxia, which happens when the baby does not get enough oxygen in the uterus, during labor or delivery, or just after birth
  • Perineal tears, tearing of your vagina and the surrounding tissues
  • Excessive bleeding, which can happen when the delivery causes tears to the uterus or if you are not able to deliver the placenta after you give birth to the baby
  • Post-term pregnancy, when your pregnancy lasts more than 42 weeks

If you have problems in childbirth, your health care provider may need to give you medicines to induce or speed up labor, use tools to help guide the baby out of the birth canal, or deliver the baby by Cesarean section.

NIH: National Institute of Child Health and Human Development


[Learn More in MedlinePlus]

Sexual Assault

What is sexual assault?

Sexual assault is any kind of sexual activity, contact, or experience that happens without your consent. That means the sexual activity happens even though you don't agree to it.

Sexual assault may happen with:

  • Physical force or threats of force
  • Sexual coercion (being pressured, tricked, threatened, or forced in a nonphysical way)
  • Alcohol or drugs, including date rape drugs

Sexual assault may also be called sexual violence or sexual abuse. It affects millions of people each year. Anyone can be a victim of sexual assault. Many victims first experience sexual assault during childhood. Most victims are girls and women. But many boys and men are also victims of sexual assault.

If you've been sexually assaulted, it's never your fault. It's something that happens to you.

What does sexual assault include?

Sexual assault is any unwanted sexual activity, including:

  • Sexual activity with physical contact, which is everything from sexual touching or kissing to rape or attempted rape
  • Sexual activity without physical contact, which includes things that may happen in person, online, or through texts, such as:
    • "Flashing" or exhibitionism (when someone shows you their genitals without asking you for permission)
    • Being forced to look at sexual images or pose for sexual photos
    • Being sent unwanted texts with sexual photos or messages
    • Voyeurism (when someone watches private sexual acts without permission)
    • Getting sexual threats or being sexually harassed (unwelcome sexual comments, requests for sexual favors, or other sexual behavior that's ongoing)

Any sexual activity that happens without your consent is sexual assault.

What does "consent" mean?

Giving your consent means that you clearly and freely say "yes" to sexual activity. Your consent means that you:

  • Know and understand what's going on.
  • Can say what you want to do and don't want to do.
  • Are not underage.
  • Are not being pressured or tricked to do things you don't want to do.

Giving consent is not:

  • Silence. Not saying "no" doesn't mean you're saying "yes."
  • Having consented in the past. Having said "yes" to sex with someone in the past doesn't mean that you've agreed to all sexual activity in the future. That's true when you're dating or in a lasting relationship.
  • Being passive and not fighting off an attacker.

You cannot give consent if you are:

  • Drugged, drunk, passed out, or asleep.
  • Mentally unable to consent due to illness or disability.
  • Underage (States have different laws about how old you must be to give legal consent to sexual activity.).
  • Sexually coerced. This means that someone is pressuring you to participate in sexual activity. Agreeing to sex under pressure is not giving consent. The pressure may include:
    • Abusing power over you, for example, a boss threatening your job.
    • Making threats to harm people you care about.
    • Making false promises to reward you for sex.
    • Threatening to end a relationship or spread rumors about you.
    • Wearing you down by constantly asking for sex or making you feel guilty or obligated.

Who commits sexual assault?

Both men and women commit sexual assault. A person who commits sexual assault may be a stranger, but more often it's someone you know, for example:

  • A friend or acquaintance
  • Someone you work with
  • A neighbor
  • A family member
  • A current or past romantic partner, including a spouse

What are the possible health effects from sexual assault?

Sexual assault may have many health effects. Many of them can affect your lifelong health and well-being. The effects may include:

  • Physical effects such as:
    • Bruises or genital injuries
    • Sexually transmitted diseases
    • Pregnancy
    • Ongoing problems with:
      • Female reproductive health
      • Digestive disorders
      • Your heart
      • Sexual health
  • Psychological effects such as:
    • Depression or anxiety
    • Thoughts about suicide
    • Post-traumatic stress disorder (PTSD)

Sexual assault victims are more likely to smoke, have an alcohol use disorder (AUD), use illegal drugs, and have risky sexual behavior. Girls who experience sexual violence are more likely to become victims of intimate partner violence in adulthood.

What can I do if I'm a victim of sexual assault?

If you are in danger or need medical care, call 911. If you can, get away from the person who assaulted you and get to a safe place as fast as you can.

You can call the National Sexual Assault Hotline at 800-656-HOPE (4673) to connect with a sexual assault service provider in your area who can direct you to local resources.

Getting support after a sexual assault may help you cope better and reduce the long-term effects. Victim services like rape crisis centers may provide a safe, healing place where you can find support.

Studies show that treatments such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) can help victims cope with depression, anxiety, and post-traumatic stress disorder.

Can sexual assault be prevented?

Sexual assault is never the victim's fault. No one who has been assaulted should be blamed for something that they did or did not do.

You can take some steps to try to be safer around others:

  • Go to parties with friends. Look out for each other. If a friend seems drunk or drugged, get them to a safe place. Have a plan for how you'll get home, too.
  • Keep control of your drink. Someone could add alcohol or put a drug in it without you knowing.
  • Meet people for the first time in a public place.
  • Listen to your "gut feelings." If you feel uncomfortable around someone, leave.
  • Pay attention to your surroundings. When walking alone, stay in busy well-lit areas. And don't wear headphones; you want to be able to hear what's happening around you.

Centers for Disease and Control and Prevention


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.