Skip to main content

O90.4 ICD-10-CM Code: Postpartum acute kidney failure

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

Coding at a Glance

Tabular directives
1 Excludes1 · 3 Excludes2

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for O90.4 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 O90.4 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).

Excludes2 — Not Included Here

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

Source: inherited from O85-O92

Coder workflow for O90.4

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

Before you code O90.4

  1. O90.4 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).

    ReviewO90.41, O90.49

    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 →

  3. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with O90.4. 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 one of the more specific codes beneath O90.4?
    Yes → Select that code and continue the checks below on its own page.
    No → O90.4 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewO90.41, O90.49

  2. Does the documentation support a condition named in O90.4’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.

    ReviewR34

Consider O90.4. 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).
Acuity
Acute or chronic as documented; when both are documented and separate codes exist, both are reported with the acute code first (Guidelines I.B.8).
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 O90.4(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with O90.4: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareR34

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

  • Excludes2 — not part of O90.4(3 notes)

    Coding workflow: The conditions named in this note are not included in O90.4. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareF53, A34, M83.0

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

Coding decision scenarios

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

Documentation: Both the condition O90.4 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).

ReviewR34

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

Postpartum acute kidney failure is a non-billable ICD-10-CM category code (O90.4). 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

  • Not billable as written — a more specific code is required: O90.41, O90.49.

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

Clinical classification (AHRQ CCSR):PRG027 — Complications specified during the puerperium (default); GEN002 — Acute and unspecified renal failure.

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 categories (Complications specified during the puerperium, Acute and unspecified renal failure).

O89.2 — Central nervous system complications of anesthesia during the puerperium, O89.3 — Toxic reaction to local anesthesia during the puerperium, O89.4 — Spinal and epidural anesthesia-induced headache during the puerperium, O89.5 — Other complications of spinal and epidural anesthesia during the puerperium, O89.6 — Failed or difficult intubation for anesthesia during the puerperium, O89.8 — Other complications of anesthesia during the puerperium, O89.9 — Complication of anesthesia during the puerperium, unspecified, O90.0 — Disruption of cesarean delivery wound, O90.1 — Disruption of perineal obstetric wound, O90.2 — Hematoma of obstetric wound, O90.41 — Hepatorenal syndrome following labor and delivery, O90.49 — Other postpartum acute kidney failure, O90.5 — Postpartum thyroiditis, O90.6 — Postpartum mood disturbance, O90.81 — Anemia of the puerperium, O90.89 — Other complications of the puerperium, not elsewhere classified, O90.9 — Complication of the puerperium, unspecified, O91.02 — Infection of nipple associated with the puerperium, O91.03 — Infection of nipple associated with lactation, O91.12 — Abscess of breast associated with the puerperium, +122 more

Contextual Map

Every relationship of O90.4 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 O90.4 with this related code in Claim Check

Hierarchy

Excludes1

Clinical classification (CCSR)

Nearest codes (13)

Change history (2)

Common coding questions

Can O90.4 be billed directly?

No. O90.4 (Postpartum acute kidney failure) 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. "O90.4 — Postpartum acute kidney failure." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/o90.4-postpartum-acute-kidney-failure

Change history

  • FY2024 — October 1, 2023
    Became a non-billable header
    FY2024 changes
  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Postpartum acute kidney failure

Nearest Codes in This Family

Official ICD-10-CM classifications closest to O90.4 in its code family, with their registry titles.

View all codes in the O90 family