O36.8911 — Maternal care for other specified fetal problems, first trimester, fetus 1
Is O36.8911 billable?
Yes, but O36.8911 is an unspecified code. O36.8911 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, O36.8911 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting O36.8911 — the more specific alternatives are listed below.
More specific alternatives
- O36.0111Maternal care for anti-D [Rh] antibodies, first trimester, fetus 1
- O36.1111Maternal care for Anti-A sensitization, first trimester, fetus 1
- O36.20X1Maternal care for hydrops fetalis, unspecified trimester, fetus 1
- O36.4XX1Maternal care for intrauterine death, fetus 1
- O36.5111Maternal care for known or suspected placental insufficiency, first trimester, fetus 1
- O36.60X1Maternal care for excessive fetal growth, unspecified trimester, fetus 1
- O36.70X1Maternal care for viable fetus in abdominal pregnancy, unspecified trimester, fetus 1
O36.8911 at a glance
| Code | O36.8911 |
|---|---|
| Description | Maternal care for other specified fetal problems, first trimester, fetus 1 |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "1" | fetus 1 |
What does the 7th character "1" mean in O36.8911?
In O36.8911, the 7th character 1 means fetus 1. The 7th character is required for O36.8911 to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does O36.8911 group to?
O36.8911 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 O36.8911 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under O36.89, the nearest indexed parent of O36.8911. Use them to find the family, then select the specific code.
- Pregnancy › complicated by › fetal › problem › specified NEC (single) (uterine)
Excludes1 — never code together — inherited from Chapter 15
The conditions below can never be reported together with O36.8911 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 O36.8911 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 O36.8911 to fully describe the condition. O36.8911 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 O36.8911, but a patient may have both at the same time. When documentation supports it, O36.8911 and the excluded code may both be reported.
Excludes2 — not included here — inherited from O36
The conditions below are not part of O36.8911, but a patient may have both at the same time. When documentation supports it, O36.8911 and the excluded code may both be reported.
- labor and delivery complicated by fetal stress (O77.-)
How long has O36.8911 existed?
O36.8911 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.