O40.1 ICD-10-CM Code: Polyhydramnios, first trimester
Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.
Coding at a Glance
- 7th character
- Required — see the character table on this page
- Tabular directives
- 1 inclusion term · 1 Excludes1
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for O40.1 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 O40.1 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.
- hydramnios
Source: inherited from O40
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).
- encounter for suspected maternal and fetal conditions ruled out (Z03.7-) Compare O40.1 vs Z03.7 →
Source: inherited from O40
7th Character Guide
"One of the following 7th characters is to be assigned to each code under category O40. 7th character 0 is for single gestations and multiple gestations where the fetus is unspecified. 7th characters 1 through 9 are for cases of multiple gestations to identify the fetus for which the code applies. The appropriate code from category O30, Multiple gestation, must also be assigned when assigning a code from category O40 that has a 7th character of 1 through 9."
- 0 — not applicable or unspecified
- 1 — fetus 1
- 2 — fetus 2
- 3 — fetus 3
- 4 — fetus 4
- 5 — fetus 5
- 9 — other fetus
Variant codes in this family
O40.1XX0, O40.1XX1, O40.1XX2, O40.1XX3, O40.1XX4, O40.1XX5, O40.1XX9
Character meanings are CMS's official 7th-character extensions for this family, as carried in each variant code's official description; variant codes are registry rows. The explanation of how the encounter character is assigned is MedCoder editorial, distinct from the official content above it.
Coder workflow for O40.1
MedCoder structured workflow — derived from this code’s own official record
Before you code O40.1
- O40.1 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).
ReviewO40.1XX0, O40.1XX1, O40.1XX2, O40.1XX3, O40.1XX4, O40.1XX5, O40.1XX9
See the relationships section · Guide: How to choose an ICD-10-CM code →
- A 7th character is required in this family. Confirm the documentation supports the character assigned — its meaning in this family is defined in the official instruction. O40.1 is not valid without one. The official 7th-character definitions for this family are quoted in the guide.
- 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 O40.1. 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 O40.1?
Yes → Select that code and continue the checks below on its own page.
No → O40.1 cannot be reported as written; query for the specificity its subcategory needs.ReviewO40.1XX0, O40.1XX1, O40.1XX2, O40.1XX3, O40.1XX4, O40.1XX5, O40.1XX9
- Does the documentation support a condition named in O40.1’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.ReviewZ03.7
- Does the documentation support one of this family’s 7th-character values?
Yes → Assign the matching 7th character; the variant codes are in the 7th Character Guide.
No → The code is invalid without its 7th character — query for the missing element.
Consider O40.1. 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).
- 7th-character basis
- The documented element this family’s 7th character records (see the official definitions in the 7th Character Guide).
- 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 O40.1(1 note)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with O40.1: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.
CompareZ03.7
See the official tabular notes · Guidelines I.A.12.a
Coding decision scenarios
Pattern scenarios for this code’s structure — decision rules, not clinical cases
Documentation: Both the condition O40.1 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).
ReviewZ03.7
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
- Not billable as written — a more specific code is required: O40.1XX0, O40.1XX1, O40.1XX2, O40.1XX3, O40.1XX4.
- Requires a 7th character. "One of the following 7th characters is to be assigned to each code under category O40. 7th character 0 is for single gestations and multiple gestations where the fetus is unspecified. 7th characters 1 through 9 are for cases of multiple gestations to identify the fetus for which the code applies. The appropriate code from category O30, Multiple gestation, must also be assigned when assigning a code from category O40 that has a 7th character of 1 through 9." Options: O40.1XX0, O40.1XX1, O40.1XX2, O40.1XX3, O40.1XX4, O40.1XX5
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 O40.1 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: Z03.7 — Encounter for suspected maternal and fetal conditions ruled out (via O40.-).
These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.
Referenced by 10 Excludes2 notes: O20 — Hemorrhage in early pregnancy (via O40.-), O20-O29 — Other maternal disorders predominantly related to pregnancy (O20-O29) (via O40.-), O21 — Excessive vomiting in pregnancy (via O40.-), O22 — Venous complications and hemorrhoids in pregnancy (via O40.-), O23 — Infections of genitourinary tract in pregnancy (via O40.-), O24 — Diabetes mellitus in pregnancy, childbirth, and the puerperium (via O40.-), O25 — Malnutrition in pregnancy, childbirth and the puerperium (via O40.-), O26 — Maternal care for other conditions predominantly related to pregnancy (via O40.-), O28 — Abnormal findings on antenatal screening of mother (via O40.-), O29 — Complications of anesthesia during pregnancy (via O40.-).
These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.
Contextual Map
Every relationship of O40.1 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 O40.1 with these 9 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
- O30-O48 — Maternal care related to the fetus and amniotic cavity and possible delivery problems[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Referenced by Excludes1 notes
- Z03.7 — Encounter for suspected maternal and fetal conditions ruled out[Excludes1](via O40.-): “known or suspected fetal anomalies affecting management of mother, not ruled out (O26.-, O35.-, O36.-, O40.-, O41.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Excludes2 notes (10)
- O20 — Hemorrhage in early pregnancy[Excludes2](via O40.-): “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O20-O29 — Other maternal disorders predominantly related to pregnancy (O20-O29)[Excludes2](via O40.-): “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O21 — Excessive vomiting in pregnancy[Excludes2](via O40.-): “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O22 — Venous complications and hemorrhoids in pregnancy[Excludes2](via O40.-): “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O23 — Infections of genitourinary tract in pregnancy[Excludes2](via O40.-): “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O24 — Diabetes mellitus in pregnancy, childbirth, and the puerperium[Excludes2](via O40.-): “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O25 — Malnutrition in pregnancy, childbirth and the puerperium[Excludes2](via O40.-): “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O26 — Maternal care for other conditions predominantly related to pregnancy[Excludes2](via O40.-): “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 2 more
Nearest codes (32)
- O40 — Polyhydramnios[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O40.1XX0 — Polyhydramnios, first trimester, not applicable or unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O40.1XX1 — Polyhydramnios, first trimester, fetus 1[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O40.1XX2 — Polyhydramnios, first trimester, fetus 2[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O40.1XX3 — Polyhydramnios, first trimester, fetus 3[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O40.1XX4 — Polyhydramnios, first trimester, fetus 4[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O40.1XX5 — Polyhydramnios, first trimester, fetus 5[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O40.1XX9 — Polyhydramnios, first trimester, other fetus[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 24 more
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 O40.1 be billed directly?
No. O40.1 (Polyhydramnios, first trimester) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.
Does O40.1 require a 7th character?
Yes. One of the following 7th characters is to be assigned to each code under category O40. 7th character 0 is for single gestations and multiple gestations where the fetus is unspecified. 7th characters 1 through 9 are for cases of multiple gestations to identify the fetus for which the code applies. The appropriate code from category O30, Multiple gestation, must also be assigned when assigning a code from category O40 that has a 7th character of 1 through 9..
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. "O40.1 — Polyhydramnios, first trimester." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/o40.1-polyhydramnios-first-trimester
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionPolyhydramnios, first trimester
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 O40.1 in its code family, with their registry titles.
- O40 — Polyhydramnios
- O40.1XX0 — Polyhydramnios, first trimester, not applicable or unspecified
- O40.1XX1 — Polyhydramnios, first trimester, fetus 1
- O40.1XX2 — Polyhydramnios, first trimester, fetus 2
- O40.1XX3 — Polyhydramnios, first trimester, fetus 3
- O40.1XX4 — Polyhydramnios, first trimester, fetus 4
- O40.1XX5 — Polyhydramnios, first trimester, fetus 5
- O40.1XX9 — Polyhydramnios, first trimester, other fetus
- O40.2 — Polyhydramnios, second trimester
- O40.2XX0 — Polyhydramnios, second trimester, not applicable or unspecified