ICD-10 O71.0
Non-Billable HeaderRupture of uterus (spontaneous) before onset of labor
About ICD-10-CM O71.0
ICD-10-CM code O71.0 represents Rupture of uterus (spontaneous) before onset of labor. This is a non-billable header code in the Pregnancy, Childbirth, and Puerperium chapter (block O71). The 2026 edition of ICD-10-CM O71.0 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Coding Tips for O71.0
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.
Type 1 Excludes
Pure excludes, these codes can never be coded together with O71.0. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- disruption of (current) cesarean delivery wound (O90.0)
- laceration of uterus, NEC (O71.81)
Medicare LCD Coverage for O71.0
Local Coverage Determinations (LCDs) from CMS MACs that list O71.0 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 O71.0.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but O71.0 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with O71.0
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 O71.0
Other codes in section O60-O77 (Complications of labor and delivery).
ICD-10 O71.0, Billing FAQ
Is ICD-10 code O71.0 billable? +
No, O71.0 is a non-billable header code. Use a more specific child code from block O71 when submitting claims.
What codes are Type 1 Excludes for O71.0? +
Type 1 Excludes (never code together with O71.0): disruption of (current) cesarean delivery wound (O90.0); laceration of uterus, NEC (O71.81)
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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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