O36.80X4 — Pregnancy with inconclusive fetal viability, fetus 4
Is O36.80X4 billable?
Yes — O36.80X4 is billable for FY2027. O36.80X4 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. O36.80X4 may be submitted for encounters from October 1, 2026 through September 30, 2027.
O36.80X4 at a glance
| Code | O36.80X4 |
|---|---|
| Description | Pregnancy with inconclusive fetal viability, fetus 4 |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "4" | fetus 4 |
What does the 7th character "4" mean in O36.80X4?
In O36.80X4, the 7th character 4 means fetus 4. The 7th character is required for O36.80X4 to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to O36.80X4?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name O36.80X4 directly.
CMS will reject this code as the principal diagnosis on an inpatient claim. It describes something other than the condition chiefly responsible for the admission.
Which MS-DRGs does O36.80X4 group to?
O36.80X4 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 O36.80X4 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under O36.80, the nearest indexed parent of O36.80X4. Use them to find the family, then select the specific code.
- Encounter › to determine fetal viability of pregnancy (with health service) (for)
- Pregnancy › complicated by › inconclusive fetal viability (single) (uterine)
Inclusion terms
Alternative wording in documentation that is classified to O36.80X4.
- Encounter to determine fetal viability of pregnancy
Excludes1 — never code together — inherited from Chapter 15
The conditions below can never be reported together with O36.80X4 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 O36
The conditions below can never be reported together with O36.80X4 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Use additional code — inherited from Chapter 15
Report an additional code alongside O36.80X4 to fully describe the condition. O36.80X4 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 O36.80X4, but a patient may have both at the same time. When documentation supports it, O36.80X4 and the excluded code may both be reported.
Excludes2 — not included here — inherited from O36
The conditions below are not part of O36.80X4, but a patient may have both at the same time. When documentation supports it, O36.80X4 and the excluded code may both be reported.
- labor and delivery complicated by fetal stress (O77.-)
How long has O36.80X4 existed?
O36.80X4 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.