O42.02: Full-term prem ROM, onset labor within 24 hours of rupture
Full-term premature rupture of membranes, onset of labor within 24 hours of rupture
Quick Clinical & Billing Summary
What is ICD-10-CM code O42.02? O42.02 represents Full-term prem ROM, onset labor within 24 hours of rupture. Under official CDC guidelines, this code is billable and specific for claim submission.
Code Hierarchy & Classification
Clinical Guidance & Documentation Standards
Associated Procedures & Medicare RVU Reimbursement
Open RVU Calculator →Typical outpatient and office evaluation procedures frequently billed alongside diagnosis O42.02:
| CPT/HCPCS | Description | Work RVU | Non-Facility Fee | Facility Fee |
|---|---|---|---|---|
| 99213 | Office/outpatient visit, established patient, 20-29 minutes (Low MDM) | 1.30 | $91.69 | $66.79 |
| 99214 | Office/outpatient visit, established patient, 30-39 minutes (Moderate MDM) | 1.92 | $133.61 | $100.21 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection (subcutaneous/intramuscular) | 0.17 | $18.34 | $12.44 |
CPT Modifier & Billing Rules
Append when a significant, separately identifiable evaluation and management service is provided on the same calendar day as a minor surgical procedure or injection.
Identifies procedures or services not normally reported together but distinct under the clinical circumstances. Use CMS X-modifiers (XE, XS, XP, XU) where required by Medicare.
Frequently Asked Questions about O42.02
Is O42.02 a billable ICD-10 code?
Yes, O42.02 is a valid, billable and specific ICD-10-CM code. It can be reported as a primary or secondary diagnosis on medical claims.
What is the ICD-10 code for Full-term prem ROM, onset labor within 24 hours of rupture?
The primary ICD-10-CM code for Full-term prem ROM, onset labor within 24 hours of rupture is O42.02.
What is the effective date of the current O42.02 code?
The code is active for fiscal year FY2027, effective starting 2026-10-01.
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