ICD-10 O12.20
Billable / SpecificGestational edema with proteinuria, unspecified trimester
About ICD-10-CM O12.20
ICD-10-CM code O12.20 represents Gestational edema with proteinuria, unspecified trimester. This is a billable/specific code in the Pregnancy, Childbirth, and Puerperium chapter (block O12). The 2026 edition of ICD-10-CM O12.20 became effective on October 1, 2025.
Coding Tips for O12.20
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.
Medicare LCD Coverage for O12.20
Local Coverage Determinations (LCDs) from CMS MACs that list O12.20 as a covered diagnosis.
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Commercial Payer Coverage
Coverage policies from major commercial payers referencing O12.20.
1 Cigna
1 Medicare
CPT Codes Commonly Billed with O12.20
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 82610 CMS LCD: Billing and Coding: Lab: Cystatin C Measurement CMS LCD
Convert O12.20 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 |
|---|---|---|
| O12.20 | 64610 | 10111 |
| O12.20 | 64620 | 10112 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To O12.20
Other codes in section O10-O16 (Edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium).
ICD-10 O12.20, Billing FAQ
Is ICD-10 code O12.20 billable? +
Yes, O12.20 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What CPT codes are commonly billed with O12.20? +
Procedures frequently paired with O12.20 include: 82610.
What ICD-9 codes does O12.20 map to? +
Per CMS GEMs, O12.20 maps to ICD-9 codes: 64610, 64620. 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 May 31, 2026.
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