Non-Billable / Non-Specific Code
ICD-10-CM O42 is the diagnosis code for Premature rupture of membranes. 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.
Always refer to the official ICD-10-CM Tabular List for complete coding guidelines. Ensure documentation supports the specificity of the code selected. When in doubt, consult a certified medical coder or the latest CMS guidelines.
Understanding where O42 sits in the ICD-10-CM classification helps ensure proper coding:
No, O42 is a non-billable/non-specific code. You should use a more specific sub-code for billing and reimbursement.
O42 is the ICD-10-CM diagnosis code for "Premature rupture of membranes". It is used by healthcare providers to classify and document this condition in medical records and insurance claims.
O42 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 has 3 sub-code(s) that provide more specific detail: O42.0, O42.1, O42.9.
Use O42 when the patients documented diagnosis matches "Premature rupture of membranes" 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 Premature rupture of membranes is O42.
No, O42 is non-billable. Use a more specific sub-code for primary diagnosis billing.
O42 is in Chapter 15 of the ICD-10-CM Tabular List.
Yes, O42 is a valid ICD-10-CM code for the 2026 fiscal year, subject to official CMS updates.