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

Compare with another code for O90.4Check this code on a claim

Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Coding at a Glance

Official instructions
1 Excludes1 · 3 Excludes2

What these terms mean →

Not billable · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

Excludes1Not reported with this code unless documented as unrelated
  • anuria and oliguria (R34)
Excludes2from O85-O92Not included here; may be reported together
  • mental and behavioral disorders associated with the puerperium (F53.-)
  • obstetrical tetanus (A34)
  • puerperal osteomalacia (M83.0)

Where it sits Source: CMS/NCHS

Under:Chapter 15: Pregnancy, Childbirth and the PuerperiumO85-O92 Complications predominantly related to the puerperiumO90 Complications of the puerperium, not elsewhere classified

Codes under O90.4 (2)

  • O90.41Hepatorenal syndrome following labor and deliveryBillable
  • O90.49Other postpartum acute kidney failureBillable

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

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: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

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 the code beneath 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. Where the codes beneath it include an unspecified code, that code applies when the record goes no further; otherwise query for the missing detail.

    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

Report the code beneath O90.4 that the documentation supports, not O90.4 itself. Then confirm that code is valid for the date of service on its own page.

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.

Don’t confuse O90.4 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of O90.4 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • R34— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of anuria and oliguria moves the case to R34; the two are not reported together unless documented as unrelated.

    Full comparison: O90.4 vs R34 →

  • O90.9— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Complication of the puerperium, unspecified” takes O90.9; specificity in the record moves it back here.

    Full comparison: O90.4 vs O90.9 →

  • F53— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of mental and behavioral disorders associated with the puerperium adds F53; it is not part of this code and both may be reported when both are documented.

    Full comparison: O90.4 vs F53 →

  • A34— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of obstetrical tetanus adds A34; it is not part of this code and both may be reported when both are documented.

    Full comparison: O90.4 vs A34 →

  • M83.0— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of puerperal osteomalacia adds M83.0; it is not part of this code and both may be reported when both are documented.

    Full comparison: O90.4 vs M83.0 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

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-derived 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)

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Common coding questions

MedCoder editorial

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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 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-derived 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 editorial 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.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

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 FY2027. 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