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O36 vs O99.713

O36 (Maternal care for other fetal problems) compared with O99.713 (Diseases of the skin and subcutaneous tissue complicating pregnancy, third trimester), from the official CMS tabular data.

Summary

These codes can be reported together when both conditions are documented, because O99.713 lists O36 under Excludes2, which marks them as distinct conditions.

Official rule
What is different?

The conditions named and billing status.O36 is “Maternal care for other fetal problems”; O99.713 is “Diseases of the skin and subcutaneous tissue complicating pregnancy, third trimester”. O36 is a non-billable header; O99.713 is billable.

Registry fact

Can these codes be reported together?

Yes, when both are documented.O99.713 lists O36 under Excludes2: “when the reason for maternal care is that the condition is known or suspected to have affected the fetus (O35-O36)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. O36 carries 2 Excludes1 notes covering other codes; the side-by-side table quotes them.

Official rule

Is there an Excludes2 relationship?

Yes.O99.713’s tabular entry: “when the reason for maternal care is that the condition is known or suspected to have affected the fetus (O35-O36)”. The note covers O36.

Official ruleGuide: Excludes1 vs Excludes2

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

One is a header.O36 is a non-billable header, but O99.713 is not one of its subdivisions.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Excludes2 relationship

O99.713
Diseases of the skin and subcutaneous tissue complicating pregnancy, third trimester
↔
O36
Maternal care for other fetal problems

What we found

Yes, when both are documented.O99.713 carries an Excludes2 note covering O36: “when the reason for maternal care is that the condition is known or suspected to have affected the fetus (O35-O36)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

  • Section I.A.12.b — Excludes2 · applies to: Excludes2

    A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.

    ICD-10-CM Official Guidelines FY2026

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

O36Maternal care for other fetal problemsO99.713Diseases of the skin and subcutaneous tissue complicating pregnancy, third trimester
Billing statusNon-billable header

Report instead: O36.0110, O36.0111, O36.0112, O36.0113, O36.0114

Billable
ClassificationO00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A)O00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A)
DefinitionMaternal care for other fetal problems is a non-billable ICD-10-CM category code (O36).Diseases of the skin and subcutaneous tissue complicating pregnancy, third trimester is a billable ICD-10-CM diagnosis code (O99.713).
7th characterOne 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
conditions which complicate the pregnant state, are aggravated by the pregnancy or are a main reason for obstetric care
Excludes1
encounter for suspected maternal and fetal conditions ruled out (Z03.7-)
placental transfusion syndromes (O43.0-)
—
Excludes2
labor and delivery complicated by fetal stress (O77.-)
herpes gestationis (O26.4)
pruritic urticarial papules and plaques of pregnancy (PUPPP) (O26.86)
when the reason for maternal care is that the condition is known or suspected to have affected the fetus (O35-O36)
Use additional code—
code to identify specific condition

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources