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ICD-10-CM 2027 diagnosis code

O12.04Gestational edema, complicating childbirth

✓ Billable / specificMaternity · age 9–64Female only

O12.04 is a valid, billable ICD-10-CM code for gestational edema, complicating childbirth. It can be reported on claims for dates of service from October 1, 2026 – September 30, 2027.

Code last changed in FY2017 (effective October 1, 2016). Source: official FY2027 ICD-10-CM release from CDC/NCHS and CMS. Page updated September 29, 2026. About our data

About O12.04

O12.04 is the ICD-10-CM diagnosis code for gestational edema, complicating childbirth. It belongs to category O12 (gestational [pregnancy-induced] edema and proteinuria without hypertension), block O10-O16 (edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium) and chapter 15 (pregnancy, childbirth and the puerperium). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Within O12.0 (gestational edema), O12.04 is specifically for gestational edema, complicating childbirth. Related codes cover unspecified trimester (O12.00), first trimester (O12.01), second trimester (O12.02), third trimester (O12.03) and complicating the puerperium (O12.05).

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

In MS-DRG v44.0, it is part of the grouping logic for DRG 998 (Principal Diagnosis Invalid as Discharge Diagnosis), in MDC 14 (Pregnancy, Childbirth and the Puerperium), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

The Medicare Code Editor treats this as a maternity diagnosis, expected only for patients age 9 through 64.

It is on the CMS list of diagnoses consistent only with female patients (the sex-conflict edit itself was retired in FY2025).

It was added in FY2017, effective October 1, 2016.

Before ICD-10, this condition was coded in ICD-9-CM as 646.11 (edema or excessive weight gain in pregnancy, without mention of hypertension, delivered, with or without mention of antepartum complication).

Notes that apply from higher levels

Instructions written at a parent level also apply to O12.04.

Broader instructions also apply from Chapter 15: Pregnancy, childbirth and the puerperium.

Alphabetic index entries

1 entries

Terms in the official ICD-10-CM index that lead to O12.04.

MS-DRG v44.0 grouping

All DRGs →

Inpatient MS-DRGs this diagnosis can group to, as the principal or a secondary diagnosis, depending on the rest of the claim.

MDC 14 · Pregnancy, Childbirth and the Puerperium

ICD-9-CM equivalent

Converter →
  • 646.11Edema or excessive weight gain in pregnancy, without mention of hypertension, delivered, with or without mention of antepartum complicationapproximate

From the CMS 2018 General Equivalence Mappings (GEMs), the final GEMs release.

Code history

  1. 2016
  2. 2017
  3. 2018
  4. 2019
  5. 2020
  6. 2021
  7. 2022
  8. 2023
  9. 2024
  10. 2025
  11. 2026
  12. 2027
  • FY2017 (effective 10/1/2016): Added
  • No changes since FY2017.

Common questions about O12.04

Is O12.04 billable?

Yes. O12.04 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).

Can O12.04 be used as a principal diagnosis?

Yes. The Medicare Code Editor doesn't restrict O12.04 as a principal diagnosis.

Is O12.04 a CC or MCC?

No. O12.04 is neither a CC nor an MCC under MS-DRG v44.0.

What DRG does O12.04 group to?

O12.04 is used in the MS-DRG v44.0 logic for MS-DRG 998 (Principal Diagnosis Invalid as Discharge Diagnosis). Which one applies depends on whether it is the principal diagnosis and on the rest of the claim.

What is the ICD-9 code for O12.04?

The CMS General Equivalence Mappings map O12.04 to ICD-9-CM 646.11.