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O36.61X9 vs O43.0

O36.61X9 (Maternal care for excessive fetal growth, first trimester, other fetus) compared with O43.0 (Placental transfusion syndromes), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Relationship

Conflict

Excludes1 conflict

O36.61X9
Maternal care for excessive fetal growth, first trimester, other fetus
↔
O43.0
Placental transfusion syndromes

Not coded here — these two are mutually exclusive.

“placental transfusion syndromes (O43.0-)”

An Excludes1 note means the two conditions cannot occur together, so the pair should not be reported for the same encounter. The sole exception is when the conditions are documented as unrelated to each other.

Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a

Can these codes be reported together?

No — do not report together. O36.61X9 carries an Excludes1 note covering O43.0: “placental transfusion syndromes (O43.0-)”

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

O36.61X9Maternal care for excessive fetal growth, first trimester, other fetusO43.0Placental transfusion syndromes
Billing statusBillableNon-billable header
ClassificationO00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A)O00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A)
DefinitionMaternal care for excessive fetal growth, first trimester, other fetus is a billable ICD-10-CM diagnosis code (O36.619).Placental transfusion syndromes is a non-billable ICD-10-CM category code (O43.0).
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
—
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Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources