Use Additional Code Notes in Chapter 15: Pregnancy, childbirth and the puerperium ICD-10-CM
A Use Additional Code note means a second code should be added, after this one, to fully describe the condition. In Chapter 15 (O00-O9A), notes printed in the chapter name other codes 72 times, and Use Additional Code Notes anywhere in the Tabular List name the chapter’s codes 6 times, covering 4 distinct codes, categories and ranges. Switch views to read the list either way.
Use Additional Code Notes by the code that carries the note
- code, if applicable, from category Z3A, Weeks of gestation, to identify the specific week of the pregnancy, if known.
- code from category O08 to identify any associated complication
- code from category O08 to identify any associated complication.
- code from category O08 to identify any associated complication.
- O03.37 Sepsis following incomplete spontaneous abortion
- O03.87 Sepsis following complete or unspecified spontaneous abortion
- O04.87 Sepsis following (induced) termination of pregnancy
- O07.37 Sepsis following failed attempted termination of pregnancy
- O08.82 Sepsis following ectopic and molar pregnancy
- O10.1 Pre-existing hypertensive heart disease complicating pregnancy, childbirth and the puerperium applies to 6 codes
- code from I11 to identify the type of hypertensive heart disease
- O10.2 Pre-existing hypertensive chronic kidney disease complicating pregnancy, childbirth and the puerperium applies to 6 codes
- code from I12 to identify the type of hypertensive chronic kidney disease
- O10.3 Pre-existing hypertensive heart and chronic kidney disease complicating pregnancy, childbirth and the puerperium applies to 6 codes
- code from I13 to identify the type of hypertensive heart and chronic kidney disease
- O10.4 Pre-existing secondary hypertension complicating pregnancy, childbirth and the puerperium applies to 6 codes
- code from I15 to identify the type of secondary hypertension
- code from O10 to identify the type of hypertension
- code to identify the superficial thrombophlebitis (I80.0-)
- O24.0 Pre-existing type 1 diabetes mellitus, in pregnancy, childbirth and the puerperium applies to 6 codes
- code from category E10 to further identify any manifestations
- O24.1 Pre-existing type 2 diabetes mellitus, in pregnancy, childbirth and the puerperium applies to 6 codes
- O24.3 Unspecified pre-existing diabetes mellitus in pregnancy, childbirth and the puerperium applies to 6 codes
- O24.8 Other pre-existing diabetes mellitus in pregnancy, childbirth, and the puerperium applies to 6 codes
- code for hepatic obstruction (K76.89)
- code, if applicable, to identify specific condition such as insulin resistance (E88.81-)
- O65.5 Obstructed labor due to abnormality of maternal pelvic organs
- code to identify abnormality of pelvic organs O34.-
- O75.3 Other infection during labor
- O80 Encounter for full-term uncomplicated delivery
- code to indicate outcome of delivery (Z37.0)
- O82 Encounter for cesarean delivery without indication
- code to indicate outcome of delivery (Z37.0)
- O85 Puerperal sepsis
- O87.0 Superficial thrombophlebitis in the puerperium
- code, if applicable, to identify the superficial vein thrombosis, such as thrombosis of superficial vessels of lower extremities (I80.0-)
- O87.1 Deep phlebothrombosis in the puerperium
- O98.7 Human immunodeficiency virus [HIV] disease complicating pregnancy, childbirth and the puerperium applies to 6 codes
- code to identify the type of obesity (E66.-)
- code(s) from F10 to identify manifestations of the alcohol use
- O99.33 Tobacco use disorder complicating pregnancy, childbirth, and the puerperium applies to 6 codes
- code from category F17 to identify type of tobacco nicotine dependence
- O99.83 Other infection carrier state complicating pregnancy, childbirth and the puerperium applies to 3 codes
- code to identify the carrier state (Z22.-)
- to identify the perpetrator of abuse (Y07.-)
- to identify the perpetrator of abuse (Y07.-)
- code to identify the perpetrator of abuse (Y07.-)
- O11 Pre-existing hypertension with pre-eclampsia: code from O10 to identify the type of hypertension
- Z31.43 Encounter for genetic testing of female for procreative management: code for recurrent pregnancy loss, if applicable (N96, O26.2-)
- O65.5 Obstructed labor due to abnormality of maternal pelvic organs: code to identify abnormality of pelvic organs O34.-
The first view lists notes printed in this chapter (a note on a category or block applies to every code beneath it). The second lists codes of this chapter named by Use Additional Code Notes anywhere in the Tabular List, including notes in other chapters.
Questions About Use Additional Code Notes
What does a Use Additional Code note mean?
A Use Additional Code note tells you to add a second code, reported after the code that carries the note, to describe the condition completely. In an etiology/manifestation pair it sits at the etiology code and points to the manifestation (Section I.A.13). The FY 2027 Tabular List has 1,491 of them; 1,174 name other codes, with 1,438 references to 389 distinct codes, categories and ranges.
Where does the additional code go?
After the code carrying the note. For etiology/manifestation pairs the Guidelines are explicit: the etiology is sequenced first, followed by the manifestation code.
Related References
Source: FY 2027 ICD-10-CM Tabular List (CMS and NCHS) and the ICD-10-CM Official Guidelines for Coding and Reporting FY 2027, Section I.A. ICD List is not affiliated with CMS or NCHS.
