O99.214 ICD-10-CM Code: Obesity complicating childbirth

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for O99.214 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Notes without a marker are published on O99.214 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for O99.214

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

Before you code O99.214

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 →

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).

The conditions the Use Additional Code note names

Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

• Excludes2 — not part of O99.214(4 notes)

  Coding workflow: The conditions named in this note are not included in O99.214. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareO24, O25, O90.5

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

• Use Additional Code — after identifying O99.214(2 notes)

  Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with O99.214 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

  ReviewE66

  See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

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

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.

Indexed Clinical Terms (2)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

• Delivery (childbirth) (labor), complicated, by, obesity (pre-existing)
• Obesity, complicating, childbirth

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Don’t confuse O99.214 with…

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

The codes most likely to be picked instead of O99.214 — 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.

• O99.210— 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 “Obesity complicating pregnancy, unspecified trimester” takes O99.210; specificity in the record moves it back here.

  Full comparison: O99.214 vs O99.210 →

• O24— 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 diabetes mellitus adds O24; it is not part of this code and both may be reported when both are documented.

  Full comparison: O99.214 vs O24 →

• O25— 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 malnutrition adds O25; it is not part of this code and both may be reported when both are documented.

  Full comparison: O99.214 vs O25 →

• O90.5— 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 postpartum thyroiditis adds O90.5; it is not part of this code and both may be reported when both are documented.

  Full comparison: O99.214 vs O90.5 →

• O35— 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 when the reason for maternal care is that the condition is known or suspected to have affected the fetus adds O35; it is not part of this code and both may be reported when both are documented.

  Full comparison: O99.214 vs O35 →

• O36— 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 when the reason for maternal care is that the condition is known or suspected to have affected the fetus adds O36; it is not part of this code and both may be reported when both are documented.

  Full comparison: O99.214 vs O36 →

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.

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 O99.214 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 O99.-), O20-O29 — Other maternal disorders predominantly related to pregnancy (O20-O29) (via O99.-), O21 — Excessive vomiting in pregnancy (via O99.-), O22 — Venous complications and hemorrhoids in pregnancy (via O99.-), O23 — Infections of genitourinary tract in pregnancy (via O99.-), O24 — Diabetes mellitus in pregnancy, childbirth, and the puerperium (via O99.-), O25 — Malnutrition in pregnancy, childbirth and the puerperium (via O99.-), O26 — Maternal care for other conditions predominantly related to pregnancy (via O99.-), O28 — Abnormal findings on antenatal screening of mother (via O99.-), O29 — Complications of anesthesia during pregnancy (via O99.-).

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

Referenced by 1 Code First instruction: E66 — Overweight and obesity (via O99.21.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 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 1 MS-DRG: DRG 998 (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):PRG023 — Complications specified during childbirth (default); END009 — Obesity.

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 childbirth, Obesity).

O98.62 — Protozoal diseases complicating childbirth, O98.72 — Human immunodeficiency virus [HIV] disease complicating childbirth, O98.82 — Other maternal infectious and parasitic diseases complicating childbirth, O98.92 — Unspecified maternal infectious and parasitic disease complicating childbirth, O99.02 — Anemia complicating childbirth, O99.12 — Other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism complicating childbirth, O99.210 — Obesity complicating pregnancy, unspecified trimester, O99.211 — Obesity complicating pregnancy, first trimester, O99.212 — Obesity complicating pregnancy, second trimester, O99.213 — Obesity complicating pregnancy, third trimester, O99.215 — Obesity complicating the puerperium, O99.284 — Endocrine, nutritional and metabolic diseases complicating childbirth, O99.314 — Alcohol use complicating childbirth, O99.324 — Drug use complicating childbirth, O99.334 — Smoking (tobacco) complicating childbirth, O99.344 — Other mental disorders complicating childbirth, O99.354 — Diseases of the nervous system complicating childbirth, O99.42 — Diseases of the circulatory system complicating childbirth, O99.52 — Diseases of the respiratory system complicating childbirth, O99.62 — Diseases of the digestive system complicating childbirth, +125 more

Same Index main term, other category

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

O77.8 — Labor and delivery complicated by other evidence of fetal stress (complicated, by, fetal, hypoxia), O77.9 — Labor and delivery complicated by fetal stress, unspecified (complicated, by, fetal, stress), O80 — Encounter for full-term uncomplicated delivery (normal), O82 — Encounter for cesarean delivery without indication (cesarean, without indication), O98.02 — Tuberculosis complicating childbirth (complicated, by, tuberculosis), O98.12 — Syphilis complicating childbirth (complicated, by, syphilis), O98.22 — Gonorrhea complicating childbirth (complicated, by, gonorrhea), O98.32 — Other infections with a predominantly sexual mode of transmission complicating childbirth (complicated, by, infection, sexually transmitted NEC), O98.42 — Viral hepatitis complicating childbirth (complicated, by, infection, viral hepatitis), O98.52 — Other viral diseases complicating childbirth (complicated, by, infection, viral NEC), O98.62 — Protozoal diseases complicating childbirth (complicated, by, protozoal disease), O98.72 — Human immunodeficiency virus [HIV] disease complicating childbirth (complicated, by, infection, human immunodeficiency virus), O98.82 — Other maternal infectious and parasitic diseases complicating childbirth (complicated, by, infection, specified NEC), O98.92 — Unspecified maternal infectious and parasitic disease complicating childbirth (complicated, by, infection), O9A.12 — Malignant neoplasm complicating childbirth (complicated, by, malignancy), O9A.22 — Injury, poisoning and certain other consequences of external causes complicating childbirth (complicated, by, injury, nonobstetric), O9A.32 — Physical abuse complicating childbirth (complicated, by, abuse, physical), O9A.42 — Sexual abuse complicating childbirth (complicated, by, abuse, sexual), O9A.52 — Psychological abuse complicating childbirth (complicated, by, abuse, psychological), Z71.3 — Dietary counseling and surveillance (dietary counseling and surveillance), +174 more

Contextual Map

Every relationship of O99.214 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 O99.214 with these 9 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
• O94-O9A — Other obstetric conditions, not elsewhere classified[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Referenced by Excludes2 notes (10)

• O20 — Hemorrhage in early pregnancy[Excludes2](via O99.-): “maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium (O98-O99)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• O20-O29 — Other maternal disorders predominantly related to pregnancy (O20-O29)[Excludes2](via O99.-): “maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium (O98-O99)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• O21 — Excessive vomiting in pregnancy[Excludes2](via O99.-): “maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium (O98-O99)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• O22 — Venous complications and hemorrhoids in pregnancy[Excludes2](via O99.-): “maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium (O98-O99)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• O23 — Infections of genitourinary tract in pregnancy[Excludes2](via O99.-): “maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium (O98-O99)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• O24 — Diabetes mellitus in pregnancy, childbirth, and the puerperium[Excludes2](via O99.-): “maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium (O98-O99)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• O25 — Malnutrition in pregnancy, childbirth and the puerperium[Excludes2](via O99.-): “maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium (O98-O99)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• O26 — Maternal care for other conditions predominantly related to pregnancy[Excludes2](via O99.-): “maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium (O98-O99)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• and 2 more

Referenced by Code First instructions

• E66 — Overweight and obesity[Code First](via O99.21.-): “obesity complicating pregnancy, childbirth and the puerperium, if applicable (O99.21-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

• PRG023 — Complications specified during childbirth[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
• END009 — Obesity[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

MS-DRG Grouper

• DRG 998 — PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS[MS-DRG]: “PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS (MDC 14)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027

Index entries

• Delivery (childbirth) (labor), complicated, by, obesity (pre-existing)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Obesity, complicating, childbirth[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (40)

• O99 — Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• O99.011 — Anemia complicating pregnancy, first trimester[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• O99.012 — Anemia complicating pregnancy, second trimester[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• O99.013 — Anemia complicating pregnancy, third trimester[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• O99.019 — Anemia complicating pregnancy, unspecified trimester[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• O99.02 — Anemia complicating childbirth[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• O99.03 — Anemia complicating the puerperium[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• O99.1 — Other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism complicating pregnancy, childbirth and the puerperium[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

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

Coding guidelines Official source data

ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section 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

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 — v44 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

Nearest Codes in This Family

Official ICD-10-CM classifications closest to O99.214 in its code family, with their registry titles.

• O99.21 — Obesity complicating pregnancy, childbirth, and the puerperium
• O99.210 — Obesity complicating pregnancy, unspecified trimester
• O99.211 — Obesity complicating pregnancy, first trimester
• O99.212 — Obesity complicating pregnancy, second trimester
• O99.213 — Obesity complicating pregnancy, third trimester
• O99.215 — Obesity complicating the puerperium
• O99.28 — Other endocrine, nutritional and metabolic diseases complicating pregnancy, childbirth and the puerperium
• O99.280 — Endocrine, nutritional and metabolic diseases complicating pregnancy, unspecified trimester
• O99.281 — Endocrine, nutritional and metabolic diseases complicating pregnancy, first trimester
• O99.282 — Endocrine, nutritional and metabolic diseases complicating pregnancy, second trimester

View all codes in the O99 family