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O43.12 ICD-10-CM Code: Velamentous insertion of umbilical cord

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

Coding at a Glance

Tabular directives
5 Excludes2

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for O43.12 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 O43.12 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.

Coder workflow for O43.12

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

Before you code O43.12

  1. O43.12 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).

    ReviewO43.121, O43.122, O43.123, O43.129

    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 →

Choose the right path

  1. Does the documentation support one of the more specific codes beneath O43.12?
    Yes → Select that code and continue the checks below on its own page.
    No → O43.12 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewO43.121, O43.122, O43.123, O43.129

Consider O43.12. 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

  • Excludes2 — not part of O43.12(5 notes)

    Coding workflow: The conditions named in this note are not included in O43.12. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareO36.5, O44, O90.89, O41.14

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

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

Velamentous insertion of umbilical cord is a non-billable ICD-10-CM category code (O43.12). 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 O43.12 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 10 Excludes2 notes: O20 — Hemorrhage in early pregnancy (via O43.-), O20-O29 — Other maternal disorders predominantly related to pregnancy (O20-O29) (via O43.-), O21 — Excessive vomiting in pregnancy (via O43.-), O22 — Venous complications and hemorrhoids in pregnancy (via O43.-), O23 — Infections of genitourinary tract in pregnancy (via O43.-), O24 — Diabetes mellitus in pregnancy, childbirth, and the puerperium (via O43.-), O25 — Malnutrition in pregnancy, childbirth and the puerperium (via O43.-), O26 — Maternal care for other conditions predominantly related to pregnancy (via O43.-), O28 — Abnormal findings on antenatal screening of mother (via O43.-), O29 — Complications of anesthesia during pregnancy (via O43.-).

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

Related Codes

Same Index main term, other category

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

O34.51 — Maternal care for incarceration of gravid uterus (cesarean, incarceration of uterus), O34.52 — Maternal care for prolapse of gravid uterus (cesarean, prolapse, uterus), O34.53 — Maternal care for retroversion of gravid uterus (cesarean, retroversion, uterus), O34.59 — Maternal care for other abnormalities of gravid uterus (cesarean, lateroversion, uterus), O34.6 — Maternal care for abnormality of vagina (cesarean, rigid, vagina), O34.7 — Maternal care for abnormality of vulva and perineum (cesarean, rigid, vulva), O34.8 — Maternal care for other abnormalities of pelvic organs (cesarean, cystocele), O36.4 — Maternal care for intrauterine death (missed), O36.51 — Maternal care for known or suspected placental insufficiency (cesarean, placental insufficiency), O42.90 — Premature rupture of membranes, unspecified as to length of time between rupture and onset of labor, unspecified weeks of gestation (complicated, by, premature rupture, membranes), O44.0 — Complete placenta previa NOS or without hemorrhage (cesarean, placenta previa), O44.1 — Complete placenta previa with hemorrhage (cesarean, placenta previa, complete, with hemorrhage), O44.2 — Partial placenta previa without hemorrhage (complicated, by, placenta, placental, previa, partial), O44.3 — Partial placenta previa with hemorrhage (complicated, by, hemorrhage, due to, placenta previa, partial), O44.4 — Low lying placenta NOS or without hemorrhage (complicated, by, placenta, placental, low), O44.5 — Low lying placenta with hemorrhage (complicated, by, hemorrhage, due to, low lying placenta), O45.8X — Other premature separation of placenta (complicated, by, Couvelaire uterus), O45.9 — Premature separation of placenta, unspecified (cesarean, abruptio placentae), O60.10 — Preterm labor with preterm delivery, unspecified trimester (preterm), O61.0 — Failed medical induction of labor (cesarean, failed, induction of labor, medical), +170 more

Contextual Map

Every relationship of O43.12 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 O43.12 with these 8 related codes in Claim Check

Hierarchy

Referenced by Excludes2 notes (10)

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 O43.12 be billed directly?

No. O43.12 (Velamentous insertion of umbilical cord) 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. "O43.12 — Velamentous insertion of umbilical cord." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/o43.12-velamentous-insertion-of-umbilical-cord

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Velamentous insertion of umbilical cord

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 O43.12 in its code family, with their registry titles.

View all codes in the O43 family