O26.86 vs O99.711

O26.86 (Pruritic urticarial papules and plaques of pregnancy (PUPPP)) compared with O99.711 (Diseases of the skin and subcutaneous tissue complicating pregnancy, first trimester), from the official CMS tabular data.

Summary

These codes can be reported together when both conditions are documented, because O26.86 lists O99.711 under Excludes2, which marks them as distinct conditions.

Official rule

What is different?

The conditions named.O26.86 is “Pruritic urticarial papules and plaques of pregnancy (PUPPP)”; O99.711 is “Diseases of the skin and subcutaneous tissue complicating pregnancy, first trimester”.

Registry fact

Can these codes be reported together?

Yes, when both are documented.O26.86 lists O99.711 under Excludes2: “maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium (O98-O99)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code.

Official rule

Is there an Excludes2 relationship?

Yes.O26.86’s tabular entry: “maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium (O98-O99)”. The note covers O99.711.

Official ruleGuide: Excludes1 vs Excludes2

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

No.Both are billable codes, and neither contains the other.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Excludes2 relationship

O26.86

Pruritic urticarial papules and plaques of pregnancy (PUPPP)

↔

O99.711

Diseases of the skin and subcutaneous tissue complicating pregnancy, first trimester

What we found

Yes, when both are documented.O26.86 carries an Excludes2 note covering O99.711: “maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium (O98-O99)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2 Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

Section I.A.12.b — Excludes2 · applies to: Excludes2
A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
ICD-10-CM Official Guidelines FY2026

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

	O26.86Pruritic urticarial papules and plaques of pregnancy (PUPPP)	O99.711Diseases of the skin and subcutaneous tissue complicating pregnancy, first trimester
Billing status	Billable	Billable
Classification	O00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A)	O00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A)
Definition	Pruritic urticarial papules and plaques of pregnancy (PUPPP) is a billable ICD-10-CM diagnosis code (O26.86).	Diseases of the skin and subcutaneous tissue complicating pregnancy, first trimester is a billable ICD-10-CM diagnosis code (O99.711).
Includes	Polymorphic eruption of pregnancy	conditions which complicate the pregnant state, are aggravated by the pregnancy or are a main reason for obstetric care
Excludes2	maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48) maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium (O98-O99)	herpes gestationis (O26.4) pruritic urticarial papules and plaques of pregnancy (PUPPP) (O26.86) when the reason for maternal care is that the condition is known or suspected to have affected the fetus (O35-O36)
Use additional code	—	code to identify specific condition

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources