O36 vs O98
O36 (Maternal care for other fetal problems) compared with O98 (Maternal infectious and parasitic diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Can these codes be reported together?
Yes, when both are documented. O98 carries an Excludes2 note covering O36: “when the reason for maternal care is that the disease is known or suspected to have affected the fetus (O35-O36)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| O36Maternal care for other fetal problems | O98Maternal infectious and parasitic diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium | |
|---|---|---|
| Billing status | Non-billable header Report instead: O36.0110, O36.0111, O36.0112, O36.0113, O36.0114 | Non-billable header |
| Classification | O00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A) | O00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A) |
| Definition | Maternal care for other fetal problems is a non-billable ICD-10-CM category code (O36). | Maternal infectious and parasitic diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium is a non-billable ICD-10-CM category code (O98). |
| 7th character | One of the following 7th characters is to be assigned to each code under category O36. 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 O36 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 of the mother, or for termination of pregnancy | the listed conditions when complicating the pregnant state, when aggravated by the pregnancy, or as a reason for obstetric care |
| Use additional code | — | code (Chapter 1), to identify specific infectious or parasitic disease |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources