Non-Billable / Non-Specific Code
ICD-10-CM O42.11 is the diagnosis code for Preterm premature rupture of membranes, onset of labor more than 24 hours following rupture. This code falls under the section "Maternal care related to the fetus and amniotic cavity and possible delivery problems" within Chapter 15 — Pregnancy, childbirth and the puerperium (O00-O9A). It is a non-billable/non-specific ICD-10-CM code that should not be used for reimbursement. A more specific sub-code is required for billing. Medical coders and healthcare providers use this code to document and classify diagnoses in electronic health records, insurance claims, and clinical databases.
Understanding where O42.11 sits in the ICD-10-CM classification helps ensure proper coding:
No, O42.11 is a non-billable/non-specific code. You should use a more specific sub-code for billing and reimbursement.
O42.11 is the ICD-10-CM diagnosis code for "Preterm premature rupture of membranes, onset of labor more than 24 hours following rupture". It is used by healthcare providers to classify and document this condition in medical records and insurance claims.
The parent code of O42.11 is O42.1 ("Premature rupture of membranes, onset of labor more than 24 hours following rupture"). O42.11 provides a more specific classification within this category.
O42.11 is located in Section O30-O48 — "Maternal care related to the fetus and amniotic cavity and possible delivery problems" within Chapter 15 of the ICD-10-CM Tabular List.
O42.11 has 4 sub-code(s) that provide more specific detail: O42.111, O42.112, O42.113, O42.119.
Use O42.11 when the patients documented diagnosis matches "Preterm premature rupture of membranes, onset of labor more than 24 hours following rupture" and the clinical documentation supports this level of specificity. Always verify with the latest ICD-10-CM guidelines and payer requirements.
The ICD-10-CM code for Preterm premature rupture of membranes, onset of labor more than 24 hours following rupture is O42.11.
No, O42.11 is non-billable. Use a more specific sub-code for primary diagnosis billing.
O42.11 is in Chapter 15 of the ICD-10-CM Tabular List.
Yes, O42.11 is a valid ICD-10-CM code for the 2026 fiscal year, subject to official CMS updates.