O43.1
Non-Billable

Malformation of placenta

Non-Billable / Non-Specific Code

What is Malformation of placenta?

ICD-10-CM O43.1 is the diagnosis code for Malformation of placenta. 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.

Coding Guidelines for O43.1

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.

ICD-10-CM Code Hierarchy

Understanding where O43.1 sits in the ICD-10-CM classification helps ensure proper coding:

Sub-Codes 4 entries
O43.10Malformation of placenta, unspecifiedNon-BillableO43.101Malformation of placenta, unspecified, first trimesterBillableO43.102Malformation of placenta, unspecified, second trimesterBillableO43.103Malformation of placenta, unspecified, third trimesterBillableO43.109Malformation of placenta, unspecified, unspecified trimesterBillableO43.11Circumvallate placentaNon-BillableO43.111Circumvallate placenta, first trimesterBillableO43.112Circumvallate placenta, second trimesterBillableO43.113Circumvallate placenta, third trimesterBillableO43.119Circumvallate placenta, unspecified trimesterBillableO43.12Velamentous insertion of umbilical cordNon-BillableO43.121Velamentous insertion of umbilical cord, first trimesterBillableO43.122Velamentous insertion of umbilical cord, second trimesterBillableO43.123Velamentous insertion of umbilical cord, third trimesterBillableO43.129Velamentous insertion of umbilical cord, unspecified trimesterBillableO43.19Other malformation of placentaNon-BillableO43.191Other malformation of placenta, first trimesterBillableO43.192Other malformation of placenta, second trimesterBillableO43.193Other malformation of placenta, third trimesterBillableO43.199Other malformation of placenta, unspecified trimesterBillable
Related Codes

Frequently Asked Questions

Is O43.1 a billable ICD-10-CM code?

No, O43.1 is a non-billable/non-specific code. You should use a more specific sub-code for billing and reimbursement.

What does O43.1 mean?

O43.1 is the ICD-10-CM diagnosis code for "Malformation of placenta". It is used by healthcare providers to classify and document this condition in medical records and insurance claims.

What is the parent code of O43.1?

The parent code of O43.1 is O43 ("Placental disorders"). O43.1 provides a more specific classification within this category.

What section is O43.1 in?

O43.1 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.

What are the sub-codes of O43.1?

O43.1 has 4 sub-code(s) that provide more specific detail: O43.10, O43.11, O43.12, O43.19.

When should I use O43.1?

Use O43.1 when the patients documented diagnosis matches "Malformation of placenta" and the clinical documentation supports this level of specificity. Always verify with the latest ICD-10-CM guidelines and payer requirements.

People Also Ask

What is the ICD-10 code for Malformation of placenta?

The ICD-10-CM code for Malformation of placenta is O43.1.

Can O43.1 be used for primary diagnosis?

No, O43.1 is non-billable. Use a more specific sub-code for primary diagnosis billing.

What chapter is O43.1 in?

O43.1 is in Chapter 15 of the ICD-10-CM Tabular List.

Is O43.1 valid for 2026?

Yes, O43.1 is a valid ICD-10-CM code for the 2026 fiscal year, subject to official CMS updates.

See Also

← PreviousO43.029Fetus-to-fetus placental transfusion syndrome, unspecified trimesterNext →O43.10Malformation of placenta, unspecified
Code Details
O43.1
Malformation of placenta
Non-Billable / Non-Specific Code
15 — Pregnancy, childbirth and the puerperium (O00-O9A)
O30-O48 — Maternal care related to the fetus and amniotic cavity and possible delivery problems
2026 ICD-10-CM