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O12.2 ICD-10-CM Code: Gestational edema with proteinuria

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FY 2026 Apr update / Pregnancy, childbirth and the puerperium (O00-O9A) / Edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium (O10-O16)

O12.2

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Gestational edema with proteinuria

Gestational edema with proteinuria

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
O12Gestational [pregnancy-induced] edema and proteinuria without hypertension
O12.2Gestational edema with proteinuria

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for O12.2 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for O12.2 in this effective period.

Related Child Codes

Official
O12.20Gestational edema with proteinuria, unspecified trimester
O12.21Gestational edema with proteinuria, first trimester
O12.22Gestational edema with proteinuria, second trimester
O12.23Gestational edema with proteinuria, third trimester
O12.24Gestational edema with proteinuria, complicating childbirth

Includes

Official

ICD-10-CM does not list Includes notes for O12.2 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for O12.2 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for O12.2 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for O12.2 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for O12.2 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

What This Code Means

O12.2 is the ICD-10-CM diagnosis code for gestational edema with proteinuria. O12.2 sits in the ICD-10-CM chapter for pregnancy, childbirth and the puerperium (o00-o9a), within the section covering edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium (o10-o16).

Header codes like O12.2 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at O12.2's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O12.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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