ICD-10 O46.002
Billable / Specific MCCAntepartum hemorrhage with coagulation defect, unspecified, second trimester
About ICD-10-CM O46.002
ICD-10-CM code O46.002 represents Antepartum hemorrhage with coagulation defect, unspecified, second trimester. This is a billable/specific code in the Pregnancy, Childbirth, and Puerperium chapter (block O46). The 2026 edition of ICD-10-CM O46.002 became effective on October 1, 2025.
Coding Tips for O46.002
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
O46.002 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.
Inpatient DRG Impact, MCC
codes Antepartum hemorrhage with coagulation defect, unspecified, second trimester. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for O46.002
Local Coverage Determinations (LCDs) from CMS MACs that list O46.002 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 O46.002.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but O46.002 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with O46.002
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 O46.002 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 |
|---|---|---|
| O46.002 | 64131 | 10000 |
| O46.002 | 64133 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To O46.002
Other codes in section O30-O48 (Maternal care related to the fetus and amniotic cavity and possible delivery problems).
ICD-10 O46.002, Billing FAQ
Is ICD-10 code O46.002 billable? +
Yes, O46.002 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is O46.002 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 O46.002 map to? +
Per CMS GEMs, O46.002 maps to ICD-9 codes: 64131, 64133. 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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