O43.19 ICD-10-CM Code: Other malformation of placenta
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 O43.19 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 O43.19 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.
- maternal care for poor fetal growth due to placental insufficiency (O36.5-) inherited from O43Compare O43.19 vs O36.5 →
- placenta previa (O44.-) inherited from O43Compare O43.19 vs O44 →
- placental polyp (O90.89) inherited from O43Compare O43.19 vs O90.89 →
- placentitis (O41.14-) inherited from O43Compare O43.19 vs O41.14 →
- premature separation of placenta abruptio placentae
Coder workflow for O43.19
MedCoder structured workflow — derived from this code’s own official record
Before you code O43.19
- O43.19 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).
ReviewO43.191, O43.192, O43.193, O43.199
See the relationships section · Guide: How to choose an ICD-10-CM code →
- “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 O43.19; 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) →
- 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).
Choose the right path
- Does the documentation support one of the more specific codes beneath O43.19?
Yes → Select that code and continue the checks below on its own page.
No → O43.19 cannot be reported as written; query for the specificity its subcategory needs.
Consider O43.19. 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).
- 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 O43.19(5 notes)
Coding workflow: The conditions named in this note are not included in O43.19. 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
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 O43.19 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 “Cyst”; these codes share that main term but sit in a different category of the Tabular List.
N83.20 — Unspecified ovarian cysts (serous), N83.29 — Other ovarian cysts (retention), N83.8 — Other noninflammatory disorders of ovary, fallopian tube and broad ligament (tubal), N85.8 — Other specified noninflammatory disorders of uterus (uterus), N88.8 — Other specified noninflammatory disorders of cervix uteri (nabothian), N89.8 — Other specified noninflammatory disorders of vagina (hymen), N90.7 — Vulvar cyst (vulva), N94.89 — Other specified conditions associated with female genital organs and menstrual cycle (canal of Nuck), O34.8 — Maternal care for other abnormalities of pelvic organs (pelvis, female, in pregnancy or childbirth), O41.8X — Other specified disorders of amniotic fluid and membranes (chorion), O65.5 — Obstructed labor due to abnormality of maternal pelvic organs (ovary, ovarian, in pregnancy or childbirth, with obstructed labor), P91.1 — Acquired periventricular cysts of newborn (periventricular, acquired, newborn), Q03.1 — Atresia of foramina of Magendie and Luschka (Dandy-Walker), Q04.6 — Congenital cerebral cysts (porencephalic), Q06.8 — Other specified congenital malformations of spinal cord (neuroenteric), Q12.8 — Other congenital lens malformations (lens, congenital), Q15.8 — Other specified congenital malformations of eye (eye NEC, congenital), Q18.0 — Sinus, fistula and cyst of branchial cleft (branchial), Q18.1 — Preauricular sinus and cyst (ear), Q18.8 — Other specified congenital malformations of face and neck (medial, face and neck), +197 more
Contextual Map
Every relationship of O43.19 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 O43.19 with these 8 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 Excludes2 notes (10)
- O20 — Hemorrhage in early pregnancy[Excludes2](via O43.-): “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 O43.-): “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 O43.-): “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 O43.-): “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 O43.-): “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 O43.-): “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 O43.-): “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 O43.-): “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 (40)
- O43 — Placental disorders[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O43.021 — Fetus-to-fetus placental transfusion syndrome, first trimester[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O43.022 — Fetus-to-fetus placental transfusion syndrome, second trimester[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O43.023 — Fetus-to-fetus placental transfusion syndrome, third trimester[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O43.029 — Fetus-to-fetus placental transfusion syndrome, unspecified trimester[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O43.1 — Malformation of placenta[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O43.10 — Malformation of placenta, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O43.101 — Malformation of placenta, unspecified, first trimester[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 32 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 O43.19 be billed directly?
No. O43.19 (Other malformation of placenta) 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. "O43.19 — Other malformation of placenta." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/o43.19-other-malformation-of-placenta
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionOther malformation of placenta
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 O43.19 in its code family, with their registry titles.
- O43.12 — Velamentous insertion of umbilical cord
- O43.121 — Velamentous insertion of umbilical cord, first trimester
- O43.122 — Velamentous insertion of umbilical cord, second trimester
- O43.123 — Velamentous insertion of umbilical cord, third trimester
- O43.129 — Velamentous insertion of umbilical cord, unspecified trimester
- O43.191 — Other malformation of placenta, first trimester
- O43.192 — Other malformation of placenta, second trimester
- O43.193 — Other malformation of placenta, third trimester
- O43.199 — Other malformation of placenta, unspecified trimester
- O43.2 — Morbidly adherent placenta