ICD-10 O02.81
Billable / SpecificInappropriate change in quantitative human chorionic gonadotropin (hCG) in early pregnancy
About ICD-10-CM O02.81
ICD-10-CM code O02.81 represents Inappropriate change in quantitative human chorionic gonadotropin (hCG) in early pregnancy. This is a billable/specific code in the Pregnancy, Childbirth, and Puerperium chapter (block O02). The 2026 edition of ICD-10-CM O02.81 became effective on October 1, 2025.
Coding Tips for O02.81
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
Most O codes require a 7th character indicating trimester (1 = first, 2 = second, 3 = third). Some require fetus identification character. Code O09 (supervision of high-risk pregnancy) is required as a secondary code when applicable.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under O02.81. Per CMS ICD-10-CM Tabular 2026.
- Biochemical pregnancy
- Chemical pregnancy
- Inappropriate level of quantitative human chorionic gonadotropin (hCG) for gestational age in early pregnancy
Medicare LCD Coverage for O02.81
Local Coverage Determinations (LCDs) from CMS MACs that list O02.81 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing O02.81.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but O02.81 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with O02.81
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert O02.81 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| O02.81 | 6310 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To O02.81
Other codes in section O00-O08 (Pregnancy with abortive outcome).
ICD-10 O02.81, Billing FAQ
Is ICD-10 code O02.81 billable? +
Yes, O02.81 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to O02.81? +
ICD-10 O02.81 includes: Biochemical pregnancy; Chemical pregnancy; Inappropriate level of quantitative human chorionic gonadotropin (hCG) for gestational age in early pregnancy.
What ICD-9 codes does O02.81 map to? +
Per CMS GEMs, O02.81 maps to ICD-9 codes: 6310. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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