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O90.49 vs O99.815

O90.49 (Other postpartum acute kidney failure) compared with O99.815 (Abnormal glucose complicating the puerperium), from the official CMS tabular data.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Summary

These codes can be reported together when both conditions are documented, because O99.815 lists O90.49 under Excludes2, which marks them as distinct conditions.

Official rule
What is different?

The conditions named.O90.49 is “Other postpartum acute kidney failure”; O99.815 is “Abnormal glucose complicating the puerperium”.

Registry fact

Can these codes be reported together?

Yes, when both are documented.O99.815 lists O90.49 under Excludes2: “postpartum acute kidney failure (O90.49)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes2 relationship?

Yes.O99.815’s tabular entry: “postpartum acute kidney failure (O90.49)”. The note covers O90.49.

Official ruleGuide: Excludes1 vs Excludes2

Nothing found in 4 other checks; 1 check does not apply
Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. O90.49 carries 1 Excludes1 note and O99.815 carries 1 Excludes1 note covering other codes; the side-by-side table quotes them.

Official rule

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

O99.815
Abnormal glucose complicating the puerperium
↔
O90.49
Other postpartum acute kidney failure

What we found

Yes, when both are documented.O99.815 carries an Excludes2 note covering O90.49: “postpartum acute kidney failure (O90.49)”

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 Excludes2Check 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 FY2027

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

Similar descriptions do not make codes interchangeable. The documentation and the official instructions decide which code applies.

Official descriptionDiffers
O90.49

Other postpartum acute kidney failure

O99.815

Abnormal glucose complicating the puerperium

StatusSame for both
Billable
Excludes1Differs
O90.49
  • anuria and oliguria (R34)
O99.815
  • gestational diabetes (O24.4-)
Excludes2Differs
O90.49
  • mental and behavioral disorders associated with the puerperium (F53.-)
  • obstetrical tetanus (A34)
  • puerperal osteomalacia (M83.0)
O99.815
  • genitourinary infections in pregnancy (O23.-)
  • infection of genitourinary tract following delivery (O86.1-O86.4)
  • malignant neoplasm complicating pregnancy, childbirth and the puerperium (O9A.1-)
  • maternal care for known or suspected abnormality of maternal pelvic organs (O34.-)
  • postpartum acute kidney failure (O90.49)
  • traumatic injuries in pregnancy (O9A.2-)
  • when the reason for maternal care is that the condition is known or suspected to have affected the fetus (O35-O36)
Use additional codeDiffers
O90.49

None at this code

O99.815
  • code to identify condition
  • code to identify specific condition
CategoryDiffers
O90.49

O90 Complications of the puerperium, not elsewhere classified

O99.815

O99 Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium

ChapterSame for both

O00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A)

IncludesDiffers
O90.49
  • Postpartum acute kidney failure
  • Puerperal anuria
  • Puerperal oliguria
O99.815
  • conditions which complicate the pregnant state, are aggravated by the pregnancy or are a main reason for obstetric care

No Code first, Code also and 7th character note at either code.

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. In a row that differs, each code’s own notes are listed under it, and the notes every code shares are listed once beneath them.

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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