ICD-10 O26.641
Billable / Specific CCIntrahepatic cholestasis of pregnancy, first trimester
About ICD-10-CM O26.641
ICD-10-CM code O26.641 represents Intrahepatic cholestasis of pregnancy, first trimester. This is a billable/specific code in the Pregnancy, Childbirth, and Puerperium chapter (block O26). The 2026 edition of ICD-10-CM O26.641 became effective on October 1, 2025.
Coding Tips for O26.641
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
O26.641 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC 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.
Inpatient DRG Impact, CC
codes Intrahepatic cholestasis of pregnancy, first trimester. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for O26.641
Local Coverage Determinations (LCDs) from CMS MACs that list O26.641 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 O26.641.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but O26.641 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with O26.641
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.
Codes Adjacent To O26.641
Other codes in section O20-O29 (Other maternal disorders predominantly related to pregnancy).
ICD-10 O26.641, Billing FAQ
Is ICD-10 code O26.641 billable? +
Yes, O26.641 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is O26.641 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
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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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