O46.012 Antepartum hemorrhage with afibrinogenemia, second trimester

Billable ICD-10-CM code, FY2026. Acts as a Major Complication or Comorbidity (MCC) as a secondary diagnosis.

Applies from O46 Antepartum hemorrhage, not elsewhere classified

Excludes1 (never code together)

• hemorrhage in early pregnancy (O20.-)
• intrapartum hemorrhage NEC (O67.-)
• placenta previa (O44.-)
• premature separation of placenta [abruptio placentae] (O45.-)

Applies from O46.01 Antepartum hemorrhage with afibrinogenemia

Applicable to

• Antepartum hemorrhage with hypofibrinogenemia

MS-DRG index

Defines the logic of DRG(s) 817-819 in MDC 14.

Approximate ICD-9-CM (GEMs)

• 641.31 Antepartum hemorrhage associated with coagulation defects, delivered, with or without mention of antepartum condition (approximate)
• 641.33 Antepartum hemorrhage associated with coagulation defects, antepartum condition or complication (approximate)

Medicare Code Edits (MCE v43.1 (April 2026))

• Maternity diagnoses (age 9 through 64): Age conflict edit. These diagnoses are clinically expected only in patients age 9 through 64.

Code annotations containing back-references to O46.012

Back-references to O46.0

• Type 1 Excludes: D65 Disseminated intravascular coagulation [defibrination syndrome] ("pregnancy, childbirth and the puerperium (O45.0, O46.0, O67.0, O72.3)")
• Type 2 Excludes: D68 Other coagulation defects ("coagulation defects complicating pregnancy, childbirth and the puerperium (O45.0, O46.0, O67.0, O72.3)")
• Type 1 Excludes: O99.1 Other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism complicating pregnancy, childbirth and the puerperium ("hemorrhage with coagulation defects (O45.-, O46.0-, O67.0, O72.3)")

Back-references to O46

• Type 1 Excludes: O67 Labor and delivery complicated by intrapartum hemorrhage, not elsewhere classified ("antepartum hemorrhage NEC (O46.-)")

Nearby codes

• O46.002 Antepartum hemorrhage with coagulation defect, unspecified, second trimester
• O46.003 Antepartum hemorrhage with coagulation defect, unspecified, third trimester
• O46.009 Antepartum hemorrhage with coagulation defect, unspecified, unspecified trimester
• O46.01 Antepartum hemorrhage with afibrinogenemia
• O46.011 Antepartum hemorrhage with afibrinogenemia, first trimester
• O46.012 Antepartum hemorrhage with afibrinogenemia, second trimester (this code)
• O46.013 Antepartum hemorrhage with afibrinogenemia, third trimester
• O46.019 Antepartum hemorrhage with afibrinogenemia, unspecified trimester
• O46.02 Antepartum hemorrhage with disseminated intravascular coagulation
• O46.021 Antepartum hemorrhage with disseminated intravascular coagulation, first trimester
• O46.022 Antepartum hemorrhage with disseminated intravascular coagulation, second trimester