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O26 vs Z03.7

O26 (Maternal care for other conditions predominantly related to pregnancy) compared with Z03.7 (Encounter for suspected maternal and fetal conditions ruled out), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

No — do not report together. Z03.7 carries an Excludes1 note covering O26: “known or suspected fetal anomalies affecting management of mother, not ruled out (O26.-, O35.-, O36.-, O40.-, O41.-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

O26Maternal care for other conditions predominantly related to pregnancyZ03.7Encounter for suspected maternal and fetal conditions ruled out
Billing statusNon-billable header

Report instead: O26.00, O26.01, O26.02, O26.03, O26.10

Non-billable header

Report instead: Z03.71, Z03.72, Z03.73, Z03.74, Z03.75

ClassificationO00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A)Z00-Z99 — Factors Influencing Health Status and Contact with Health Services (Z00-Z99)
DefinitionMaternal care for other conditions predominantly related to pregnancy is a non-billable ICD-10-CM category code (O26).Encounter for suspected maternal and fetal conditions ruled out is a non-billable ICD-10-CM category code (Z03.7).
Includes
Encounter for suspected maternal and fetal conditions not found

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources