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O24.811 ICD-10-CM Code: Other pre-existing diabetes mellitus in pregnancy, first trimester

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
2 Excludes2 · 4 use-additional codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 817 — OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC (MDC 14)
  • MS-DRG 818 — OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC (MDC 14)
  • MS-DRG 819 — OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC (MDC 14)
  • MS-DRG 831 — OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC (MDC 14)
  • MS-DRG 832 — OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC (MDC 14)
  • MS-DRG 833 — OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC (MDC 14)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for O24.811 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 O24.811 itself; “inherited from” names the category or block whose note applies here.

Excludes2 — Not Included Here

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

Source: inherited from O20-O29

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code (for):
  • from categories E08, E09 and E13 to further identify any manifestation
  • injectable non-insulin antidiabetic drugs (Z79.85)
  • long-term (current) use of insulin (Z79.4)

Source: inherited from O24.8

Coder workflow for O24.811

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

Before you code O24.811

  1. “Other” (NEC) means the condition is specified in the record but no dedicated code captures it. Confirm the documented form is not one a sibling code names before settling on O24.811; if the record states no specifics at all, the unspecified sibling applies instead. “Other” codes are for documented conditions the classification gives no specific code; “unspecified” codes are for records lacking the detail (Guidelines I.A.9.a, I.A.9.b).

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

  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 →

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 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.
Any detail beyond this code’s title
What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

  • Excludes2 — not part of O24.811(2 notes)

    Coding workflow: The conditions named in this note are not included in O24.811. 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

  • Use Additional Code — after identifying O24.811(4 notes)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with O24.811 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewE08, E09, E13, Z79.85, Z79.4

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

Coding question: Is a second code reported with O24.811?

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).

ReviewE08, E09, E13, Z79.85, Z79.4

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 O24.811 with…

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

The codes most likely to be picked instead of O24.811 — 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.

  • O24.819— 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 “Other pre-existing diabetes mellitus in pregnancy, unspecified trimester” takes O24.819; specificity in the record moves it back here.

    Full comparison: O24.811 vs O24.819 →

  • O30— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of maternal care related to the fetus and amniotic cavity and possible delivery problems adds O30; it is not part of this code and both may be reported when both are documented.

    Full comparison: O24.811 vs O30 →

  • O48— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of maternal care related to the fetus and amniotic cavity and possible delivery problems adds O48; it is not part of this code and both may be reported when both are documented.

    Full comparison: O24.811 vs O48 →

  • O98— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium adds O98; it is not part of this code and both may be reported when both are documented.

    Full comparison: O24.811 vs O98 →

  • O99— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium adds O99; it is not part of this code and both may be reported when both are documented.

    Full comparison: O24.811 vs O99 →

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

Other pre-existing diabetes mellitus in pregnancy, first trimester is a billable ICD-10-CM diagnosis code (O24.811).

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

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A)

g. Diabetes mellitus in pregnancy Diabetes mellitus is a significant complicating factor in pregnancy. Pregnant patients who are diabetic should be assigned a code from category O24, Diabetes mellitus in pregnancy, childbirth, and the puerperium, first, followed by the appropriate diabetes code(s) (E08-E13) from Chapter 4.

Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A)

Codes for gestational diabetes are in subcategory O24.4, Gestational diabetes mellitus. No other code from category O24, Diabetes mellitus in pregnancy, childbirth, and the puerperium, should be used with a code from O24.4.

Verify Before Coding

  • Age-restricted: the Medicare Code Editor lists this as a maternity (age 9-64) diagnosis; other ages are presumed incorrect.
  • CC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.

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 O24.811 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: R73 — Elevated blood glucose level (via O24.-).

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

Referenced by 1 Excludes2 note: O99.2 — Endocrine, nutritional and metabolic diseases complicating pregnancy, childbirth and the puerperium (via O24.-).

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

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 250 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 6 MS-DRGs: DRG 817 (MDC 14), DRG 818 (MDC 14), DRG 819 (MDC 14), DRG 831 (MDC 14), DRG 832 (MDC 14), DRG 833 (MDC 14).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):PRG019 — Diabetes or abnormal glucose tolerance complicating pregnancy; childbirth; or the puerperium (default); END002 — Diabetes mellitus without complication.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

O24.113 — Pre-existing type 2 diabetes mellitus, in pregnancy, third trimester, O24.119 — Pre-existing type 2 diabetes mellitus, in pregnancy, unspecified trimester, O24.12 — Pre-existing type 2 diabetes mellitus, in childbirth, O24.13 — Pre-existing type 2 diabetes mellitus, in the puerperium, O24.311 — Unspecified pre-existing diabetes mellitus in pregnancy, first trimester, O24.312 — Unspecified pre-existing diabetes mellitus in pregnancy, second trimester, O24.313 — Unspecified pre-existing diabetes mellitus in pregnancy, third trimester, O24.319 — Unspecified pre-existing diabetes mellitus in pregnancy, unspecified trimester, O24.32 — Unspecified pre-existing diabetes mellitus in childbirth, O24.33 — Unspecified pre-existing diabetes mellitus in the puerperium, O24.812 — Other pre-existing diabetes mellitus in pregnancy, second trimester, O24.813 — Other pre-existing diabetes mellitus in pregnancy, third trimester, O24.819 — Other pre-existing diabetes mellitus in pregnancy, unspecified trimester, O24.82 — Other pre-existing diabetes mellitus in childbirth, O24.83 — Other pre-existing diabetes mellitus in the puerperium, O24.911 — Unspecified diabetes mellitus in pregnancy, first trimester, O24.912 — Unspecified diabetes mellitus in pregnancy, second trimester, O24.913 — Unspecified diabetes mellitus in pregnancy, third trimester, O24.919 — Unspecified diabetes mellitus in pregnancy, unspecified trimester, O24.92 — Unspecified diabetes mellitus in childbirth, +229 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Diabetes or abnormal glucose tolerance complicating pregnancy; childbirth; or the puerperium, Diabetes mellitus without complication).

O24.415 — Gestational diabetes mellitus in pregnancy, controlled by oral hypoglycemic drugs, O24.419 — Gestational diabetes mellitus in pregnancy, unspecified control, O24.420 — Gestational diabetes mellitus in childbirth, diet controlled, O24.424 — Gestational diabetes mellitus in childbirth, insulin controlled, O24.425 — Gestational diabetes mellitus in childbirth, controlled by oral hypoglycemic drugs, O24.429 — Gestational diabetes mellitus in childbirth, unspecified control, O24.430 — Gestational diabetes mellitus in the puerperium, diet controlled, O24.434 — Gestational diabetes mellitus in the puerperium, insulin controlled, O24.435 — Gestational diabetes mellitus in puerperium, controlled by oral hypoglycemic drugs, O24.439 — Gestational diabetes mellitus in the puerperium, unspecified control, O24.812 — Other pre-existing diabetes mellitus in pregnancy, second trimester, O24.813 — Other pre-existing diabetes mellitus in pregnancy, third trimester, O24.819 — Other pre-existing diabetes mellitus in pregnancy, unspecified trimester, O24.82 — Other pre-existing diabetes mellitus in childbirth, O24.83 — Other pre-existing diabetes mellitus in the puerperium, O24.911 — Unspecified diabetes mellitus in pregnancy, first trimester, O24.912 — Unspecified diabetes mellitus in pregnancy, second trimester, O24.913 — Unspecified diabetes mellitus in pregnancy, third trimester, O24.919 — Unspecified diabetes mellitus in pregnancy, unspecified trimester, O24.92 — Unspecified diabetes mellitus in childbirth, +34 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

HbA1c Test (Glycated Hemoglobin), Blood Glucose Test

Contextual Map

Every relationship of O24.811 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 O24.811 with these 2 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

  • R73 — Elevated blood glucose level[Excludes1](via O24.-): “diabetes mellitus in pregnancy, childbirth and the puerperium (O24.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes2 notes

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 14 — Pregnancy, Childbirth and the Puerperium[MDC crossing]: “Pregnancy, Childbirth and the Puerperium — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 94 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

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

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
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section 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
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 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. "O24.811 — Other pre-existing diabetes mellitus in pregnancy, first trimester." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/o24.811-other-pre-existing-diabetes-mellitus-in-pregnancy-first-trimester

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Other pre-existing diabetes mellitus in pregnancy, first trimester

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 O24.811 in its code family, with their registry titles.

View all codes in the O24 family