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O43.12 ICD-10-CM Code: Velamentous insertion of umbilical cord

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FY 2026 Apr update / Pregnancy, childbirth and the puerperium (O00-O9A) / Maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)

O43.12

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

Velamentous insertion of umbilical cord

Velamentous insertion of umbilical cord

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
O43Placental disorders
O43.1Malformation of placenta
O43.12Velamentous insertion of umbilical cord

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for O43.12 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for O43.12 in this effective period.

Related Child Codes

Official
O43.121Velamentous insertion of umbilical cord, first trimester
O43.122Velamentous insertion of umbilical cord, second trimester
O43.123Velamentous insertion of umbilical cord, third trimester
O43.129Velamentous insertion of umbilical cord, unspecified trimester

Includes

Official

ICD-10-CM does not list Includes notes for O43.12 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for O43.12 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for O43.12 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for O43.12 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for O43.12 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

O43.12 is the ICD-10-CM diagnosis code for velamentous insertion of umbilical cord. O43.12 sits in the ICD-10-CM chapter for pregnancy, childbirth and the puerperium (o00-o9a), within the section covering maternal care related to the fetus and amniotic cavity and possible delivery problems (o30-o48).

Header codes like O43.12 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 O43.12'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 O43.12 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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