ICD-10 O88.213
Billable / Specific MCCThromboembolism in pregnancy, third trimester
About ICD-10-CM O88.213
ICD-10-CM code O88.213 represents Thromboembolism in pregnancy, third trimester. This is a billable/specific code in the Pregnancy, Childbirth, and Puerperium chapter (block O88). The 2026 edition of ICD-10-CM O88.213 became effective on October 1, 2025.
Coding Tips for O88.213
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
O88.213 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 Thromboembolism in pregnancy, third 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 O88.213
Local Coverage Determinations (LCDs) from CMS MACs that list O88.213 as a covered diagnosis.
Showing top 7. Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing O88.213.
2 Medicare
CPT Codes Commonly Billed with O88.213
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 O88.213 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 |
|---|---|---|
| O88.213 | 67321 | 10000 |
| O88.213 | 67323 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To O88.213
Other codes in section O85-O92 (Complications predominantly related to the puerperium).
ICD-10 O88.213, Billing FAQ
Is ICD-10 code O88.213 billable? +
Yes, O88.213 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is O88.213 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 O88.213 map to? +
Per CMS GEMs, O88.213 maps to ICD-9 codes: 67321, 67323. 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 July 16, 2026.
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