ICD-10 · PDGM grouping
O42 Premature rupture of membranes
All 18 codes in the O42 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
ICD-10-CM FY2027 · CMS grouper v07.2.26
Codes in family
18
Can lead a claim
12
Cannot lead a claim
6
What CMS assigns to O42
12 of the 18 codes group to MMTA - Other; 6 are assigned no clinical group. None of the 18 is assigned a comorbidity subgroup. 12 of the 18 can lead a claim.
Every code in O42
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| O42.0 Premature rupture of membranes, onset of labor within 24 hours of rupture | ||||
| O42.00 | Premature rupture of membranes, onset of labor within 24 hours of rupture, unspecified weeks of gestationCMS: Prem ROM, onset labor w/n 24 hr of rupt, unsp weeks of gest | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| O42.01 Preterm premature rupture of membranes, onset of labor within 24 hours of rupture | ||||
| O42.011 | Preterm premature rupture of membranes, onset of labor within 24 hours of rupture, first trimesterCMS: Pretrm prem ROM, onset labor w/n 24 hours of rupt, first tri | Can lead a claim | A | None |
| O42.012 | Preterm premature rupture of membranes, onset of labor within 24 hours of rupture, second trimesterCMS: Pretrm prem ROM, onset labor w/n 24 hours of rupt, 2nd tri | Can lead a claim | A | None |
| O42.013 | Preterm premature rupture of membranes, onset of labor within 24 hours of rupture, third trimesterCMS: Pretrm prem ROM, onset labor w/n 24 hours of rupt, third tri | Can lead a claim | A | None |
| O42.019 | Preterm premature rupture of membranes, onset of labor within 24 hours of rupture, unspecified trimesterCMS: Pretrm prem ROM, onset labor w/n 24 hours of rupt, unsp tri | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| O42.02 | Full-term premature rupture of membranes, onset of labor within 24 hours of ruptureCMS: Full-term prem ROM, onset labor within 24 hours of rupture | Can lead a claim | A | None |
| O42.1 Premature rupture of membranes, onset of labor more than 24 hours following rupture | ||||
| O42.10 | Premature rupture of membranes, onset of labor more than 24 hours following rupture, unspecified weeks of gestationCMS: Prem ROM, onset labor > 24 hr fol rupt, unsp weeks of gest | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| O42.11 Preterm premature rupture of membranes, onset of labor more than 24 hours following rupture | ||||
| O42.111 | Preterm premature rupture of membranes, onset of labor more than 24 hours following rupture, first trimesterCMS: Pretrm prem ROM, onset labor > 24 hours fol rupt, first tri | Can lead a claim | A | None |
| O42.112 | Preterm premature rupture of membranes, onset of labor more than 24 hours following rupture, second trimesterCMS: Pretrm prem ROM, onset labor > 24 hours fol rupt, second tri | Can lead a claim | A | None |
| O42.113 | Preterm premature rupture of membranes, onset of labor more than 24 hours following rupture, third trimesterCMS: Pretrm prem ROM, onset labor > 24 hours fol rupt, third tri | Can lead a claim | A | None |
| O42.119 | Preterm premature rupture of membranes, onset of labor more than 24 hours following rupture, unspecified trimesterCMS: Pretrm prem ROM, onset labor > 24 hours fol rupt, unsp tri | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| O42.12 | Full-term premature rupture of membranes, onset of labor more than 24 hours following ruptureCMS: Full-term premature ROM, onset labor > 24 hours fol rupture | Can lead a claim | A | None |
| O42.9 Premature rupture of membranes, unspecified as to length of time between rupture and onset of labor | ||||
| O42.90 | Premature rupture of membranes, unspecified as to length of time between rupture and onset of labor, unspecified weeks of gestationCMS: Prem ROM, 7th0 betw rupt & onst labr, unsp weeks of gest | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| O42.91 Preterm premature rupture of membranes, unspecified as to length of time between rupture and onset of labor | ||||
| O42.911 | Preterm premature rupture of membranes, unspecified as to length of time between rupture and onset of labor, first trimesterCMS: Pretrm prem ROM, unsp time betw rupt and onset labr, 1st tri | Can lead a claim | A | None |
| O42.912 | Preterm premature rupture of membranes, unspecified as to length of time between rupture and onset of labor, second trimesterCMS: Pretrm prem ROM, unsp time betw rupt and onset labr, 2nd tri | Can lead a claim | A | None |
| O42.913 | Preterm premature rupture of membranes, unspecified as to length of time between rupture and onset of labor, third trimesterCMS: Pretrm prem ROM, unsp time betw rupt and onst labr, 3rd tri | Can lead a claim | A | None |
| O42.919 | Preterm premature rupture of membranes, unspecified as to length of time between rupture and onset of labor, unspecified trimesterCMS: Pretrm prem ROM, unsp time betw rupt and onst labr, unsp tri | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| O42.92 | Full-term premature rupture of membranes, unspecified as to length of time between rupture and onset of laborCMS: Full-term prem ROM, unsp time betw rupture and onset labor | Can lead a claim | A | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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