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O43.213 ICD-10-CM Code: Placenta accreta, third trimester

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

Coding at a Glance

Tabular directives
1 Excludes1 · 5 Excludes2 · 1 code-also instruction

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 v43, Appendix B.

  • MS-DRG 769 — POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES (MDC 14)
  • MS-DRG 776 — POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES (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 O43.213 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 O43.213 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 O43.2

Excludes2 — Not Included Here

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

Code Also

Additional codes that may be required to fully describe the encounter.

  • associated third stage postpartum hemorrhage, if applicable (O72.0)

Source: inherited from O43.2

Coder workflow for O43.213

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

Before you code O43.213

  1. 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 →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with O43.213. 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 a condition named in O43.213’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.

    ReviewO73

Consider O43.213. Then review the Code Also note, and 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 O43.213(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with O43.213: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareO73

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

  • Excludes2 — not part of O43.213(5 notes)

    Coding workflow: The conditions named in this note are not included in O43.213. 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

  • Code Also — related condition(1 note)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    ReviewO72.0

    See the official tabular notes · Guidelines I.A.17

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition O43.213 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).

ReviewO73

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

Placenta accreta, third trimester is a billable ICD-10-CM diagnosis code (O43.213).

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

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. 1 Code Also note — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  2. 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  3. 5 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • Age-restricted: the Medicare Code Editor lists this as a maternity (age 9-64) diagnosis; other ages are presumed incorrect.

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 O43.213 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: O73 — Retained placenta and membranes, without hemorrhage (via O43.21.-).

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 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.

Referenced by 1 Code Also instruction: O72.0 — Third-stage hemorrhage (via O43.2.-).

These codes suggest coding this condition alongside when both are present.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 2 MS-DRGs: DRG 769 (MDC 14), DRG 776 (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):PRG018 — Maternal care related to disorders of the placenta and placental implantation (default).

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 category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Maternal care related to disorders of the placenta and placental implantation).

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, O43.211 — Placenta accreta, first trimester, O43.212 — Placenta accreta, second trimester, O43.219 — Placenta accreta, unspecified trimester, O43.221 — Placenta increta, first trimester, O43.222 — Placenta increta, second trimester, O43.223 — Placenta increta, third trimester, O43.229 — Placenta increta, unspecified trimester, O43.231 — Placenta percreta, first trimester, O43.232 — Placenta percreta, second trimester, O43.233 — Placenta percreta, third trimester, O43.239 — Placenta percreta, unspecified trimester, O43.811 — Placental infarction, first trimester, +103 more

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

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.

Partial Thromboplastin Time (PTT) Test

Contextual Map

Every relationship of O43.213 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 O43.213 with these 10 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes (10)

Referenced by Code Also instructions

  • O72.0 — Third-stage hemorrhage[Code Also](via O43.2.-): “type of adherent placenta (O43.2-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

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 · 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

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
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 — v43 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. "O43.213 — Placenta accreta, third trimester." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/o43.213-placenta-accreta-third-trimester

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Placenta accreta, third 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 O43.213 in its code family, with their registry titles.

View all codes in the O43 family