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ICD-10-CM 2027 diagnosis code

O26.649Intrahepatic cholestasis of pregnancy, unspecified trimester

✓ Billable / specificMaternity · age 9–64

O26.649 is a valid, billable ICD-10-CM code for intrahepatic cholestasis of pregnancy, unspecified trimester. It can be reported on claims for dates of service from October 1, 2026 – September 30, 2027.

Code last changed in FY2024 (effective October 1, 2023). Source: official FY2027 ICD-10-CM release from CDC/NCHS and CMS. Page updated September 29, 2026. About our data

About O26.649

O26.649 is the ICD-10-CM diagnosis code for intrahepatic cholestasis of pregnancy, unspecified trimester. It belongs to category O26 (maternal care for other conditions predominantly related to pregnancy), block O20-O29 (other maternal disorders predominantly related to pregnancy) 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 O26.64, choose O26.649 (unspecified trimester) only when documentation doesn't support a more specific option: first trimester (O26.641), second trimester (O26.642) and third trimester (O26.643).

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 817 (Other Antepartum Diagnoses with O.R. Procedures with MCC, relative weight 2.0534), DRG 818 (Other Antepartum Diagnoses with O.R. Procedures with CC, relative weight 1.2942), DRG 819 (Other Antepartum Diagnoses with O.R. Procedures without CC/MCC, relative weight 0.7739), DRG 831 (Other Antepartum Diagnoses without O.R. Procedures with MCC, relative weight 1.1558), DRG 832 (Other Antepartum Diagnoses without O.R. Procedures with CC, relative weight 0.7585) and DRG 833 (Other Antepartum Diagnoses without O.R. Procedures without CC/MCC, relative weight 0.5002), 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 was added in FY2024, effective October 1, 2023.

Notes that apply from higher levels

Instructions written at a parent level also apply to O26.649.

› From O26.64 Intrahepatic cholestasis of pregnancy
Use additional code
  • code for hepatic obstruction (K76.89)
› From O26.6 Liver and biliary tract disorders in pregnancy, childbirth and the puerperium
Excludes2
  • hepatorenal syndrome following labor and delivery (O90.41)
Use additional code
  • code to identify the specific disorder

Broader instructions also apply from O20-O29 Other maternal disorders predominantly related to pregnancy and Chapter 15: Pregnancy, childbirth and the puerperium.

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.

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
  • FY2024 (effective 10/1/2023): Added
  • No changes since FY2024.

Common questions about O26.649

Is O26.649 billable?

Yes. O26.649 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).

Can O26.649 be used as a principal diagnosis?

Yes. The Medicare Code Editor doesn't restrict O26.649 as a principal diagnosis.

Is O26.649 a CC or MCC?

No. O26.649 is neither a CC nor an MCC under MS-DRG v44.0.

What DRG does O26.649 group to?

O26.649 is used in the MS-DRG v44.0 logic for MS-DRG 817 (Other Antepartum Diagnoses with O.R. Procedures with MCC), MS-DRG 818 (Other Antepartum Diagnoses with O.R. Procedures with CC), MS-DRG 819 (Other Antepartum Diagnoses with O.R. Procedures without CC/MCC), MS-DRG 831 (Other Antepartum Diagnoses without O.R. Procedures with MCC), MS-DRG 832 (Other Antepartum Diagnoses without O.R. Procedures with CC) and MS-DRG 833 (Other Antepartum Diagnoses without O.R. Procedures without CC/MCC). Which one applies depends on whether it is the principal diagnosis and on the rest of the claim.