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Compare/O35 vs Z03.7

O35 vs Z03.7

O35 (Maternal care for known or suspected fetal abnormality and damage) 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. O35 carries an Excludes1 note covering Z03.7: “encounter for suspected maternal and fetal conditions ruled out (Z03.7-)”

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

No — do not report together. Z03.7 carries an Excludes1 note covering O35: “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

O35Maternal care for known or suspected fetal abnormality and damageZ03.7Encounter for suspected maternal and fetal conditions ruled out
Billing statusNon-billable header

Report instead: O35.00X0, O35.00X1, O35.00X2, O35.00X3, O35.00X4

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 known or suspected fetal abnormality and damage is a non-billable ICD-10-CM category code (O35).Encounter for suspected maternal and fetal conditions ruled out is a non-billable ICD-10-CM category code (Z03.7).
7th characterOne of the following 7th characters is to be assigned to each code under category O35. 7th character 0 is for single gestations and multiple gestations where the fetus is unspecified. 7th characters 1 through 9 are for cases of multiple gestations to identify the fetus for which the code applies. The appropriate code from category O30, Multiple gestation, must also be assigned when assigning a code from category O35 that has a 7th character of 1 through 9.
Includes
the listed conditions in the fetus as a reason for hospitalization or other obstetric care to the mother, or for termination of pregnancy
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