O35.04X2 — Maternal care for (suspected) central nervous system malformation or damage in fetus, encephalocele, fetus 2
Is O35.04X2 billable?
Yes — O35.04X2 is billable for FY2027. O35.04X2 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. O35.04X2 may be submitted for encounters from October 1, 2026 through September 30, 2027.
O35.04X2 at a glance
| Code | O35.04X2 |
|---|---|
| Description | Maternal care for (suspected) central nervous system malformation or damage in fetus, encephalocele, fetus 2 |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "2" | fetus 2 |
What does the 7th character "2" mean in O35.04X2?
In O35.04X2, the 7th character 2 means fetus 2. The 7th character is required for O35.04X2 to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does O35.04X2 group to?
O35.04X2 sits in MDC 14 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 817Other Antepartum Diagnoses with O.R. Procedures with MCCsurgical
- 818Other Antepartum Diagnoses with O.R. Procedures with CCsurgical
- 819Other Antepartum Diagnoses with O.R. Procedures without CC/MCCsurgical
How is O35.04X2 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under O35.04, the nearest indexed parent of O35.04X2. Use them to find the family, then select the specific code.
- Pregnancy › complicated by › fetal › encephalocele (single) (uterine)
Excludes1 — never code together — inherited from Chapter 15
The conditions below can never be reported together with O35.04X2 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- supervision of normal pregnancy (Z34.-)
Excludes1 — never code together — inherited from O35
The conditions below can never be reported together with O35.04X2 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- encounter for suspected maternal and fetal conditions ruled out (Z03.7-)
Use additional code — inherited from Chapter 15
Report an additional code alongside O35.04X2 to fully describe the condition. O35.04X2 is sequenced first.
- code, if applicable, from category Z3A, Weeks of gestation, to identify the specific week of the pregnancy, if known.
Excludes2 — not included here — inherited from Chapter 15
The conditions below are not part of O35.04X2, but a patient may have both at the same time. When documentation supports it, O35.04X2 and the excluded code may both be reported.
Excludes2 — not included here — inherited from O35.0
The conditions below are not part of O35.04X2, but a patient may have both at the same time. When documentation supports it, O35.04X2 and the excluded code may both be reported.
- chromosomal abnormality in fetus (O35.1-)
Code also — inherited from O35
Two codes may be needed to describe the condition fully. Whether O35.04X2 is sequenced first depends on the reason for the encounter.
- any associated maternal condition
How long has O35.04X2 existed?
O35.04X2 first appears in FY2023.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.