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O29.3X1 ICD-10-CM Code: Toxic reaction to local anesthesia during pregnancy, first trimester

Compare with another codeCheck this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
1 inclusion term · 4 Excludes2 · 1 use-additional code

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

Use additional codeReport with this code when documented
  • code, if necessary, to identify the complication
Excludes2Not included here; may be reported together
  • complications of anesthesia during labor and delivery (O74.-)
  • complications of anesthesia during the puerperium (O89.-)
  • maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)
  • maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium (O98-O99)
IncludesWhat this code covers
  • maternal complications arising from the administration of a general, regional or local anesthetic, analgesic or other sedation during pregnancy

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 817 — OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC (MDC 14)
  • MS-DRG 818 — OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC (MDC 14)
  • MS-DRG 819 — OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC (MDC 14)
  • MS-DRG 831 — OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC (MDC 14)
  • MS-DRG 832 — OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC (MDC 14)
  • MS-DRG 833 — OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC (MDC 14)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for O29.3X1 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on O29.3X1 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • maternal complications arising from the administration of a general, regional or local anesthetic, analgesic or other sedation during pregnancy

Source: inherited from O29

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code, if necessary, to identify the complication

Source: inherited from O29

Coder workflow for O29.3X1

MedCoder structured workflow — derived from this code’s own official record

Before you code O29.3X1

  1. Confirm the condition is documented as complicating the pregnancy, childbirth, or the puerperium, and check the trimester where the code carries one and the fetus character where the category requires it. Chapter 15 codes belong on the maternal record only and take sequencing priority over codes from other chapters. It is the provider’s responsibility to state that a condition is not affecting the pregnancy; the trimester is assigned from the documentation (Guidelines I.C.15.a, I.C.15.a.1, I.C.15.a.3).

    Guide: How to choose an ICD-10-CM code →

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Trimester
Assigned from the documented trimester at the encounter, or the trimester in which the condition developed for inpatient stays (Guidelines I.C.15.a.3).
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

  • Excludes2 — not part of O29.3X1(4 notes)

    Coding workflow: The conditions named in this note are not included in O29.3X1. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareO74, O89

    See the official tabular notes · Guidelines I.A.12.b

  • Use Additional Code — after identifying O29.3X1(1 note)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with O29.3X1 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with O29.3X1?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse O29.3X1 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of O29.3X1 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • O29.3X9— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Toxic reaction to local anesthesia during pregnancy, unspecified trimester” takes O29.3X9; specificity in the record moves it back here.

    Full comparison: O29.3X1 vs O29.3X9 →

  • O74— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of complications of anesthesia during labor and delivery adds O74; it is not part of this code and both may be reported when both are documented.

    Full comparison: O29.3X1 vs O74 →

  • O89— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of complications of anesthesia during the puerperium adds O89; it is not part of this code and both may be reported when both are documented.

    Full comparison: O29.3X1 vs O89 →

  • O30— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of maternal care related to the fetus and amniotic cavity and possible delivery problems adds O30; it is not part of this code and both may be reported when both are documented.

    Full comparison: O29.3X1 vs O30 →

  • O48— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of maternal care related to the fetus and amniotic cavity and possible delivery problems adds O48; it is not part of this code and both may be reported when both are documented.

    Full comparison: O29.3X1 vs O48 →

  • O98— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium adds O98; it is not part of this code and both may be reported when both are documented.

    Full comparison: O29.3X1 vs O98 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Toxic reaction to local anesthesia during pregnancy, first trimester is a billable ICD-10-CM diagnosis code (O29.3X1).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

  • Age-restricted: the Medicare Code Editor lists this as a maternity (age 9-64) diagnosis; other ages are presumed incorrect.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name O29.3X1 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 23 Excludes1 notes: T36 — Poisoning by, adverse effect of and underdosing of systemic antibiotics (via O29.3.-), T36-T39 — Antibiotics & Anti-infectives (T36-T39) (via O29.3.-), T36-T50 — Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50) (via O29.3.-), T37 — Poisoning by, adverse effect of and underdosing of other systemic anti-infectives and antiparasitics (via O29.3.-), T38 — Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified (via O29.3.-), T39 — Poisoning by, adverse effect of and underdosing of nonopioid analgesics, antipyretics and antirheumatics (via O29.3.-), T40 — Poisoning by, adverse effect of and underdosing of narcotics and psychodysleptics [hallucinogens] (via O29.3.-), T40-T41 — Analgesics & Antipyretics (T40-T41) (via O29.3.-), T41 — Poisoning by, adverse effect of and underdosing of anesthetics and therapeutic gases (via O29.3.-), T41 — Poisoning by, adverse effect of and underdosing of anesthetics and therapeutic gases (via O29.-), T42 — Poisoning by, adverse effect of and underdosing of antiepileptic, sedative- hypnotic and antiparkinsonism drugs (via O29.3.-), T42-T43 — Anticonvulsants & Psychotropics (T42-T43) (via O29.3.-), T43 — Poisoning by, adverse effect of and underdosing of psychotropic drugs, not elsewhere classified (via O29.3.-), T44 — Poisoning by, adverse effect of and underdosing of drugs primarily affecting the autonomic nervous system (via O29.3.-), T44-T46 — Cardiovascular & Gastrointestinal (T44-T46) (via O29.3.-), T45 — Poisoning by, adverse effect of and underdosing of primarily systemic and hematological agents, not elsewhere classified (via O29.3.-), T46 — Poisoning by, adverse effect of and underdosing of agents primarily affecting the cardiovascular system (via O29.3.-), T47 — Poisoning by, adverse effect of and underdosing of agents primarily affecting the gastrointestinal system (via O29.3.-), T47-T50 — Hormones & Systemic Agents (T47-T50) (via O29.3.-), T48 — Poisoning by, adverse effect of and underdosing of agents primarily acting on smooth and skeletal muscles and the respiratory system (via O29.3.-), +3 more.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 1 Excludes2 note: T88 — Other complications of surgical and medical care, not elsewhere classified (via O29.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 6 MS-DRGs: DRG 817 (MDC 14), DRG 818 (MDC 14), DRG 819 (MDC 14), DRG 831 (MDC 14), DRG 832 (MDC 14), DRG 833 (MDC 14).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):PRG025 — Anesthesia complications during pregnancy (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Anesthesia complications during pregnancy).

O29.193 — Other cardiac complications of anesthesia during pregnancy, third trimester, O29.199 — Other cardiac complications of anesthesia during pregnancy, unspecified trimester, O29.211 — Cerebral anoxia due to anesthesia during pregnancy, first trimester, O29.212 — Cerebral anoxia due to anesthesia during pregnancy, second trimester, O29.213 — Cerebral anoxia due to anesthesia during pregnancy, third trimester, O29.219 — Cerebral anoxia due to anesthesia during pregnancy, unspecified trimester, O29.291 — Other central nervous system complications of anesthesia during pregnancy, first trimester, O29.292 — Other central nervous system complications of anesthesia during pregnancy, second trimester, O29.293 — Other central nervous system complications of anesthesia during pregnancy, third trimester, O29.299 — Other central nervous system complications of anesthesia during pregnancy, unspecified trimester, O29.3X2 — Toxic reaction to local anesthesia during pregnancy, second trimester, O29.3X3 — Toxic reaction to local anesthesia during pregnancy, third trimester, O29.3X9 — Toxic reaction to local anesthesia during pregnancy, unspecified trimester, O29.40 — Spinal and epidural anesthesia induced headache during pregnancy, unspecified trimester, O29.41 — Spinal and epidural anesthesia induced headache during pregnancy, first trimester, O29.42 — Spinal and epidural anesthesia induced headache during pregnancy, second trimester, O29.43 — Spinal and epidural anesthesia induced headache during pregnancy, third trimester, O29.5X1 — Other complications of spinal and epidural anesthesia during pregnancy, first trimester, O29.5X2 — Other complications of spinal and epidural anesthesia during pregnancy, second trimester, O29.5X3 — Other complications of spinal and epidural anesthesia during pregnancy, third trimester, +45 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Reaction”, “Effect, adverse”; these codes share that main term but sit in a different category of the Tabular List.

F99 — Mental disorder, not otherwise specified (psychogenic), G97.1 — Other reaction to spinal and lumbar puncture (lumbar puncture), J70.0 — Acute pulmonary manifestations due to radiation (radiation NOS, pneumonitis), J70.1 — Chronic and other pulmonary manifestations due to radiation (radiation NOS, fibrosis of lung), L43.2 — Lichenoid drug reaction (drug NEC, lichenoid), L56.0 — Drug phototoxic response (drug NEC, phototoxic), L56.1 — Drug photoallergic response (drug NEC, photoallergic), L56.8 — Other specified acute skin changes due to ultraviolet radiation (ultraviolet NOS, dermatitis or eczema, acute), L59.8 — Other specified disorders of the skin and subcutaneous tissue related to radiation (infrared NOS, dermatitis or eczema), L59.9 — Disorder of the skin and subcutaneous tissue related to radiation, unspecified (radiation NOS, skin), O74.4 — Toxic reaction to local anesthesia during labor and delivery (toxic, to local anesthesia, in labor and delivery), O74.5 — Spinal and epidural anesthesia-induced headache during labor and delivery (anesthesia, spinal and epidural, headache, in labor and delivery), O74.6 — Other complications of spinal and epidural anesthesia during labor and delivery (anesthesia, spinal and epidural, specified NEC, in labor and delivery), O74.8 — Other complications of anesthesia during labor and delivery (anesthesia, specified NEC, in labor and delivery), O74.9 — Complication of anesthesia during labor and delivery, unspecified (anesthesia, in labor and delivery), O89.3 — Toxic reaction to local anesthesia during the puerperium (toxic, to local anesthesia, postpartum, puerperal), O89.4 — Spinal and epidural anesthesia-induced headache during the puerperium (anesthesia, spinal and epidural, headache, postpartum, puerperal), O89.5 — Other complications of spinal and epidural anesthesia during the puerperium (anesthesia, spinal and epidural, specified NEC, postpartum, puerperal), O89.8 — Other complications of anesthesia during the puerperium (anesthesia, specified NEC, postpartum, puerperal), O89.9 — Complication of anesthesia during the puerperium, unspecified (anesthesia, postpartum, puerperal), +76 more

Contextual Map

Every relationship of O29.3X1 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run O29.3X1 with these 9 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes (23)

Referenced by Excludes2 notes

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 14 — Pregnancy, Childbirth and the Puerperium[MDC crossing]: “Pregnancy, Childbirth and the Puerperium — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 94 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Nearest codes (40)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "O29.3X1 — Toxic reaction to local anesthesia during pregnancy, first trimester." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/o29.3x1-toxic-reaction-to-local-anesthesia-during-pregnancy-first-trimester

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Toxic reaction to local anesthesia during pregnancy, first trimester

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to O29.3X1 in its code family, with their registry titles.

View all codes in the O29 family