O20 ICD-10-CM Code: Hemorrhage in early pregnancy
Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.
Coding at a Glance
- Tabular directives
- 1 inclusion term · 1 Excludes1 · 2 Excludes2
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for O20 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025
Notes without a marker are published on O20 itself; “inherited from” names the category or block whose note applies here.
Includes
Conditions the official ICD-10-CM tabular list includes under this code.
- hemorrhage before completion of 20 weeks gestation
Excludes1 — Not Coded Here
Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
- pregnancy with abortive outcome (O00-O08) Compare O20 vs O00 →
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48) Compare O20 vs O30 →
- maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium (O98-O99) Compare O20 vs O98 →
Source: inherited from O20-O29
Coder workflow for O20
MedCoder structured workflow — derived from this code’s own official record
Before you code O20
- O20 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).
See the relationships section · Guide: How to choose an ICD-10-CM code →
- 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).
- Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with O20. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).
Choose the right path
- Does the documentation support one of the more specific codes beneath O20?
Yes → Select that code and continue the checks below on its own page.
No → O20 cannot be reported as written; query for the specificity its subcategory needs. - Does the documentation support a condition named in O20’s Excludes1 note?
Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
No → Continue.
Consider O20. Then 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).
Official instructions as workflow
Excludes1 — check before selecting O20(1 note)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with O20: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.
See the official tabular notes · Guidelines I.A.12.a
Excludes2 — not part of O20(2 notes)
Coding workflow: The conditions named in this note are not included in O20. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
See the official tabular notes · Guidelines I.A.12.b
Coding decision scenarios
Pattern scenarios for this code’s structure — decision rules, not clinical cases
Documentation: Both the condition O20 describes and a condition named in its Excludes1 note are documented for the same encounter.
Coding question: Can both codes be reported?
Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.
Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).
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
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 O20 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 1 Excludes1 note: O46 — Antepartum hemorrhage, not elsewhere classified.
These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.
Contextual Map
Every relationship of O20 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 O20 with these 16 related codes in Claim Check
Hierarchy
- O00-O9A — Chapter 15: Pregnancy, Childbirth and the Puerperium (O00-O9A) (O00-O9A)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O20-O29 — Other maternal disorders predominantly related to pregnancy[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Excludes1
- O00 — Ectopic pregnancy[Excludes1]: “pregnancy with abortive outcome (O00-O08)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O01 — Hydatidiform mole[Excludes1]: “pregnancy with abortive outcome (O00-O08)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O02 — Other abnormal products of conception[Excludes1]: “pregnancy with abortive outcome (O00-O08)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O03 — Spontaneous abortion[Excludes1]: “pregnancy with abortive outcome (O00-O08)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O04 — Complications following (induced) termination of pregnancy[Excludes1]: “pregnancy with abortive outcome (O00-O08)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O07 — Failed attempted termination of pregnancy[Excludes1]: “pregnancy with abortive outcome (O00-O08)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O08 — Complications following ectopic and molar pregnancy[Excludes1]: “pregnancy with abortive outcome (O00-O08)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Excludes2 (18)
- O30 — Multiple gestation[Excludes2]: “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O31 — Complications specific to multiple gestation[Excludes2]: “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O32 — Maternal care for malpresentation of fetus[Excludes2]: “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O33 — Maternal care for disproportion[Excludes2]: “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O34 — Maternal care for abnormality of pelvic organs[Excludes2]: “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O35 — Maternal care for known or suspected fetal abnormality and damage[Excludes2]: “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O36 — Maternal care for other fetal problems[Excludes2]: “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O40 — Polyhydramnios[Excludes2]: “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- and 10 more
Referenced by Excludes1 notes
- O46 — Antepartum hemorrhage, not elsewhere classified[Excludes1]: “hemorrhage in early pregnancy (O20.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Nearest codes
- O20.0 — Threatened abortion[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O20.8 — Other hemorrhage in early pregnancy[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O20.9 — Hemorrhage in early pregnancy, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
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 O20 be billed directly?
No. O20 (Hemorrhage in early pregnancy) 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. "O20 — Hemorrhage in early pregnancy." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/o20-hemorrhage-in-early-pregnancy
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionHemorrhage in early pregnancy
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 O20 in its code family, with their registry titles.