ICD-10 O04.81
Billable / Specific MCCShock following (induced) termination of pregnancy
About ICD-10-CM O04.81
ICD-10-CM code O04.81 represents Shock following (induced) termination of pregnancy. This is a billable/specific code in the Pregnancy, Childbirth, and Puerperium chapter (block O04). The 2026 edition of ICD-10-CM O04.81 became effective on October 1, 2025.
Coding Tips for O04.81
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
O04.81 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
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 O04.81. Per CMS ICD-10-CM Tabular 2026.
- Circulatory collapse following (induced) termination of pregnancy
- Shock (postprocedural) following (induced) termination of pregnancy
Type 1 Excludes
Pure excludes, these codes can never be coded together with O04.81. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- shock due to infection following (induced) termination of pregnancy (O04.87)
Inpatient DRG Impact, MCC
codes Shock following (induced) termination of pregnancy. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for O04.81
Local Coverage Determinations (LCDs) from CMS MACs that list O04.81 as a covered diagnosis.
Showing top 7. Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing O04.81.
2 Medicare
CPT Codes Commonly Billed with O04.81
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 O04.81 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 |
|---|---|---|
| O04.81 | 63552 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To O04.81
Other codes in section O00-O08 (Pregnancy with abortive outcome).
ICD-10 O04.81, Billing FAQ
Is ICD-10 code O04.81 billable? +
Yes, O04.81 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 O04.81? +
ICD-10 O04.81 includes: Circulatory collapse following (induced) termination of pregnancy; Shock (postprocedural) following (induced) termination of pregnancy.
What codes are Type 1 Excludes for O04.81? +
Type 1 Excludes (never code together with O04.81): shock due to infection following (induced) termination of pregnancy (O04.87)
Is O04.81 a CC or MCC for inpatient DRG? +
Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What ICD-9 codes does O04.81 map to? +
Per CMS GEMs, O04.81 maps to ICD-9 codes: 63552. Useful for legacy data review and historical claim analysis.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team