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O22.4 ICD-10-CM Code: Hemorrhoids in 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
6 Excludes1 · 4 Excludes2

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for O22.4 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on O22.4 itself; “inherited from” names the category or block whose note applies here.

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).

Source: inherited from O22

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Coder workflow for O22.4

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

Before you code O22.4

  1. O22.4 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).

    ReviewO22.40, O22.41, O22.42, O22.43

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

  2. 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 →

  3. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with O22.4. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support one of the more specific codes beneath O22.4?
    Yes → Select that code and continue the checks below on its own page.
    No → O22.4 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewO22.40, O22.41, O22.42, O22.43

  2. Does the documentation support a condition named in O22.4’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.

    ReviewO03.9, O08.7, O07.35, O04.85, O03.89

Consider O22.4. 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 O22.4(6 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with O22.4: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareO03.9, O08.7, O07.35, O04.85, O03.89

    See the official tabular notes · Guidelines I.A.12.a

  • Excludes2 — not part of O22.4(4 notes)

    Coding workflow: The conditions named in this note are not included in O22.4. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareO88, O87

    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 O22.4 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).

ReviewO03.9, O08.7, O07.35, O04.85, O03.89

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.

Don’t confuse O22.4 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of O22.4 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • O03.9— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of abortion NOS moves the case to O03.9; the two are not reported together unless documented as unrelated.

    Full comparison: O22.4 vs O03.9 →

  • O08.7— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of ectopic or molar pregnancy moves the case to O08.7; the two are not reported together unless documented as unrelated.

    Full comparison: O22.4 vs O08.7 →

  • O07.35— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of failed attempted abortion moves the case to O07.35; the two are not reported together unless documented as unrelated.

    Full comparison: O22.4 vs O07.35 →

  • O04.85— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of induced abortion moves the case to O04.85; the two are not reported together unless documented as unrelated.

    Full comparison: O22.4 vs O04.85 →

  • O03.89— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of spontaneous abortion moves the case to O03.89; the two are not reported together unless documented as unrelated.

    Full comparison: O22.4 vs O03.89 →

  • O22.9— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Venous complication in pregnancy, unspecified” takes O22.9; specificity in the record moves it back here.

    Full comparison: O22.4 vs O22.9 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Code Overview

Hemorrhoids in pregnancy is a non-billable ICD-10-CM category code (O22.4). 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.

Indexed Clinical Terms (1)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

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 O22.4 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: K64 — Hemorrhoids and perianal venous thrombosis.

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

Referenced by 3 Excludes2 notes: O87 — Venous complications and hemorrhoids in the puerperium (via O22.-), O99.4 — Diseases of the circulatory system complicating pregnancy, childbirth and the puerperium (via O22.-), O99.6 — Diseases of the digestive system complicating pregnancy, childbirth and the puerperium.

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

Referenced by 2 Code First instructions: I80 — Phlebitis and thrombophlebitis (via O22.-), I82 — Other venous embolism and thrombosis (via O22.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

Related Codes

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Varix”, “Hemorrhoids”; these codes share that main term but sit in a different category of the Tabular List.

I85.11 — Secondary esophageal varices with bleeding (esophagus, secondary, bleeding), I86.0 — Sublingual varices (sublingual), I86.1 — Scrotal varices (scrotum), I86.2 — Pelvic varices (ovary), I86.3 — Vulval varices (labia), I86.4 — Gastric varices (stomach), I86.8 — Varicose veins of other specified sites (orbit), K64.0 — First degree hemorrhoids (1st degree), K64.1 — Second degree hemorrhoids (2nd degree), K64.2 — Third degree hemorrhoids (3rd degree), K64.3 — Fourth degree hemorrhoids (4th degree), K64.4 — Residual hemorrhoidal skin tags (external), K64.5 — Perianal venous thrombosis (thrombosed), K64.8 — Other hemorrhoids (internal), K64.9 — Unspecified hemorrhoids, O43.89 — Other placental disorders (placenta), O87.2 — Hemorrhoids in the puerperium (complicating, puerperium), O87.4 — Varicose veins of lower extremity in the puerperium (complicating, puerperium), O87.8 — Other venous complications in the puerperium (complicating, puerperium, genital), Q27.8 — Other specified congenital malformations of peripheral vascular system (congenital), +66 more

Contextual Map

Every relationship of O22.4 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 O22.4 with these 6 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes

Referenced by Code First instructions

  • I80 — Phlebitis and thrombophlebitis[Code First](via O22.-): “phlebitis and thrombophlebitis complicating pregnancy, childbirth and the puerperium (O22.-, O87.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • I82 — Other venous embolism and thrombosis[Code First](via O22.-): “pregnancy, childbirth and the puerperium (O22.-, O87.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Index entries

  • Hemorrhoids (bleeding) (without mention of degree), complicating, pregnancy[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (40)

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 O22.4 be billed directly?

No. O22.4 (Hemorrhoids in 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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 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. "O22.4 — Hemorrhoids in pregnancy." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/o22.4-hemorrhoids-in-pregnancy

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Hemorrhoids in pregnancy

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, 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 O22.4 in its code family, with their registry titles.

View all codes in the O22 family