O31.41X9 ICD-10-CM Code: Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, other fetus
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- 7th character
- Required — see the character table on this page
- Tabular directives
- 3 Excludes2
Code Set: New for FY2027 — not valid before October 1, 2026.
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for O31.41X9 in the official ICD-10-CM tabular list, quoted as published.
Notes without a marker are published on O31.41X9 itself; “inherited from” names the category or block whose note applies here.
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- delayed delivery of second twin, triplet, etc. (O63.2) Compare O31.41X9 vs O63.2 →
- malpresentation of one fetus or more (O32.9) Compare O31.41X9 vs O32.9 →
- placental transfusion syndromes (O43.0-) Compare O31.41X9 vs O43.0 →
Source: inherited from O31
7th Character Guide
"One of the following 7th characters is to be assigned to each code under category O31. 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 O31 that has a 7th character of 1 through 9."
- 0 — not applicable or unspecified
- 1 — fetus 1
- 2 — fetus 2
- 3 — fetus 3
- 4 — fetus 4
- 5 — fetus 5
- 9 — other fetus (this page’s code)
Variant codes in this family
O31.41X0, O31.41X1, O31.41X2, O31.41X3, O31.41X4, O31.41X5, O31.41X9
Character meanings are CMS's official 7th-character extensions for this family, as carried in each variant code's official description; variant codes are registry rows. The explanation of how the encounter character is assigned is MedCoder editorial, distinct from the official content above it.
Coder workflow for O31.41X9
MedCoder structured workflow — derived from this code’s own official record
Before you code O31.41X9
- A 7th character is required in this family. Confirm the documentation supports the character assigned — its meaning in this family is defined in the official instruction. This page’s code carries “9”. The official 7th-character definitions for this family are quoted in the guide.
- 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).
Choose the right path
- Does the documentation support one of this family’s 7th-character values?
Yes → Assign the matching 7th character; the variant codes are in the 7th Character Guide.
No → The code is invalid without its 7th character — query for the missing element.
Consider O31.41X9. Then confirm the code is valid for the date of service in the Verify section.
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).
- 7th-character basis
- The documented element this family’s 7th character records (see the official definitions in the 7th Character Guide).
- 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).
- Fetus affected
- For multiple gestations, the fetus the condition affects, as documented.
Official instructions as workflow
Excludes2 — not part of O31.41X9(3 notes)
Coding workflow: The conditions named in this note are not included in O31.41X9. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
See the official tabular notes · Guidelines I.A.12.b
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.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Official Coding Guidelines
Official source data — quoted verbatim from the CMS/NCHS Official Guidelines
Official source data — quoted verbatim from the CMS/NCHS Official Guidelines
Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.
Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A)
6) 7th character for fetus identification Where applicable, a 7th character is to be assigned for certain categories (O31, O32, O33.3 - O33.6, O35, O36, O40, O41, O60.1, O60.2, O64, and O69) to identify the fetus for which the complication code applies.
Verify Before Coding
- No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.
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 structured relationships — computed from published CMS and AHRQ datasets
Other codes that name O31.41X9 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 10 Excludes2 notes: O20 — Hemorrhage in early pregnancy (via O31.-), O20-O29 — Other maternal disorders predominantly related to pregnancy (O20-O29) (via O31.-), O21 — Excessive vomiting in pregnancy (via O31.-), O22 — Venous complications and hemorrhoids in pregnancy (via O31.-), O23 — Infections of genitourinary tract in pregnancy (via O31.-), O24 — Diabetes mellitus in pregnancy, childbirth, and the puerperium (via O31.-), O25 — Malnutrition in pregnancy, childbirth and the puerperium (via O31.-), O26 — Maternal care for other conditions predominantly related to pregnancy (via O31.-), O28 — Abnormal findings on antenatal screening of mother (via O31.-), O29 — Complications of anesthesia during pregnancy (via O31.-).
These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.
Contextual Map
Every relationship of O31.41X9 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 O31.41X9 with these 8 related codes in Claim Check
Hierarchy
- O00-O9A — Chapter 15: Pregnancy, Childbirth and the Puerperium (O00-O9A) (O00-O9A)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O30-O48 — Maternal care related to the fetus and amniotic cavity and possible delivery problems[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Referenced by Excludes2 notes (10)
- O20 — Hemorrhage in early pregnancy[Excludes2](via O31.-): “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O20-O29 — Other maternal disorders predominantly related to pregnancy (O20-O29)[Excludes2](via O31.-): “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O21 — Excessive vomiting in pregnancy[Excludes2](via O31.-): “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O22 — Venous complications and hemorrhoids in pregnancy[Excludes2](via O31.-): “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O23 — Infections of genitourinary tract in pregnancy[Excludes2](via O31.-): “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O24 — Diabetes mellitus in pregnancy, childbirth, and the puerperium[Excludes2](via O31.-): “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O25 — Malnutrition in pregnancy, childbirth and the puerperium[Excludes2](via O31.-): “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- O26 — Maternal care for other conditions predominantly related to pregnancy[Excludes2](via O31.-): “maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- and 2 more
Nearest codes (40)
- O31 — Complications specific to multiple gestation[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O31.33X3 — Continuing pregnancy after elective fetal reduction of one fetus or more, third trimester, fetus 3[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O31.33X4 — Continuing pregnancy after elective fetal reduction of one fetus or more, third trimester, fetus 4[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O31.33X5 — Continuing pregnancy after elective fetal reduction of one fetus or more, third trimester, fetus 5[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O31.33X9 — Continuing pregnancy after elective fetal reduction of one fetus or more, third trimester, other fetus[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O31.4 — Continuing pregnancy after vanishing twin syndrome of one fetus or more[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O31.40 — Continuing pregnancy after vanishing twin syndrome of one fetus or more, unspecified trimester[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O31.40X0 — Continuing pregnancy after vanishing twin syndrome of one fetus or more, unspecified trimester, not applicable or unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 32 more
Change history
- FY2027 — Will be added to the code set[Change history]— CMS release files (code change ledger) · icd10cm-fy2027
Common coding questions
Does O31.41X9 require a 7th character?
Yes. One of the following 7th characters is to be assigned to each code under category O31. 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 O31 that has a 7th character of 1 through 9..
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 FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Coding guidelines Official source data
- ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 2026) 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 structured 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 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.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
Change history
- Upcoming · effective FY2027 — October 1, 2026Will be added to the code setContinuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, other fetusFY2027 changes
Nearest Codes in This Family
Official ICD-10-CM classifications closest to O31.41X9 in its code family, with their registry titles.
- O31.41X1 — Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, fetus 1
- O31.41X2 — Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, fetus 2
- O31.41X3 — Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, fetus 3
- O31.41X4 — Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, fetus 4
- O31.41X5 — Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, fetus 5
- O31.42 — Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester
- O31.42X0 — Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester, not applicable or unspecified
- O31.42X1 — Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester, fetus 1
- O31.42X2 — Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester, fetus 2
- O31.42X3 — Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester, fetus 3