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O11 ICD-10-CM Code: Pre-existing hypertension with pre-eclampsia

Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.

Coding at a Glance

Tabular directives
2 inclusion terms · 1 use-additional code

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for O11 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • conditions in O10 complicated by pre-eclampsia
  • pre-eclampsia superimposed pre-existing hypertension

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code from O10 to identify the type of hypertension

Coder workflow for O11

MedCoder structured workflow — derived from this code’s own official record

Before you code O11

  1. O11 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewO11.1, O11.2, O11.3, O11.4, O11.5, O11.9

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. O11’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

    Guide: Combination codes →

  3. Confirm the condition is documented as complicating the pregnancy, childbirth, or the puerperium, and check the trimester where the code carries one and the fetus character where the category requires it. Chapter 15 codes belong on the maternal record only and take sequencing priority over codes from other chapters. It is the provider’s responsibility to state that a condition is not affecting the pregnancy; the trimester is assigned from the documentation (Guidelines I.C.15.a, I.C.15.a.1, I.C.15.a.3).

    Guide: How to choose an ICD-10-CM code →

Choose the right path

  1. Does the documentation support one of the more specific codes beneath O11?
    Yes → Select that code and continue the checks below on its own page.
    No → O11 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewO11.1, O11.2, O11.3, O11.4, O11.5, O11.9

Consider O11. Then work the Use Additional Code note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Trimester
Assigned from the documented trimester at the encounter, or the trimester in which the condition developed for inpatient stays (Guidelines I.C.15.a.3).
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

  • Use Additional Code — after identifying O11(1 note)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with O11 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewO10

    See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Only one of the components this code’s title joins is documented.

Coding question: Is O11 supported?

Path: Review the code for the documented component on its own.

Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with O11?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

ReviewO10

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Pre-existing hypertension with pre-eclampsia is a non-billable ICD-10-CM category code (O11). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name O11 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 2 Excludes1 notes across 2 chapters: I10 — Essential (primary) hypertension, O14 — Pre-eclampsia.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 9 Excludes2 notes across 2 chapters: I10-I1A — Hypertensive diseases (I10-I1A), I11 — Hypertensive heart disease, I12 — Hypertensive chronic kidney disease, I13 — Hypertensive heart and chronic kidney disease, I15 — Secondary hypertension, I16 — Hypertensive crisis, I1A — Other hypertension, O10 — Pre-existing hypertension complicating pregnancy, childbirth and the puerperium, O99.4 — Diseases of the circulatory system complicating pregnancy, childbirth and the puerperium.

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Contextual Map

Every relationship of O11 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run O11 with these 10 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

  • I10 — Essential (primary) hypertension[Excludes1]: “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • O14 — Pre-eclampsia[Excludes1]: “pre-existing hypertension with pre-eclampsia (O11)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes2 notes (9)

  • I10-I1A — Hypertensive diseases (I10-I1A)[Excludes2]: “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • I11 — Hypertensive heart disease[Excludes2]: “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • I12 — Hypertensive chronic kidney disease[Excludes2]: “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • I13 — Hypertensive heart and chronic kidney disease[Excludes2]: “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • I15 — Secondary hypertension[Excludes2]: “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • I16 — Hypertensive crisis[Excludes2]: “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • I1A — Other hypertension[Excludes2]: “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • O10 — Pre-existing hypertension complicating pregnancy, childbirth and the puerperium[Excludes2]: “pre-existing hypertension with superimposed pre-eclampsia complicating pregnancy, childbirth and the puerperium (O11.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • and 1 more

Nearest codes

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Common coding questions

Can O11 be billed directly?

No. O11 (Pre-existing hypertension with pre-eclampsia) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "O11 — Pre-existing hypertension with pre-eclampsia." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/o11-pre-existing-hypertension-with-pre-eclampsia

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Pre-existing hypertension with pre-eclampsia

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to O11 in its code family, with their registry titles.