Skip to main content
ICD-10/O35.05X9

O35.05X9 ICD-10-CM Code: Maternal care for (suspected) central nervous system malformation or damage in fetus, holoprosencephaly, other fetus

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

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, 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.

Official Registry Overview & Definition

Maternal care for (suspected) central nervous system malformation or damage in fetus, holoprosencephaly, other fetus is a billable ICD-10-CM diagnosis code (O35.059).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for O35.05X9 in the official ICD-10-CM tabular list.

Includes

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

  • the listed conditions in the fetus as a reason for hospitalization or other obstetric care to the mother, or for termination of pregnancy

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Excludes2 — Not Included Here

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

Code Also

Additional codes that may be required to fully describe the encounter.

  • any associated maternal condition

Change history

  • FY2023 — 2022-10-01
    Added to the code set
    Maternal care for (suspected) central nervous system malformation or damage in fetus, holoprosencephaly, other fetus
    FY2023 changes

Verify Before Coding

  • Billable — reportable as written.
  • 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.

Contextual Map

Every relationship of O35.05X9 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.

Hierarchy

  • O00-O9A — Chapter 15: Pregnancy, Childbirth and the Puerperium (O00-O9A) (O00-O9A) [Hierarchy]
  • O30-O48 — Maternal care related to the fetus and amniotic cavity and possible delivery problems [Hierarchy]
  • O35 — Clinical Diagnosis [Hierarchy]
  • O35.0 — Clinical Diagnosis [Hierarchy]
  • O35.05 — Clinical Diagnosis [Hierarchy]
  • O35.05X — Clinical Diagnosis [Hierarchy]

Referenced by Excludes1 notes

  • Z03.7 — Encounter for suspected maternal and fetal conditions ruled out [Excludes1](via O35.-): “known or suspected fetal anomalies affecting management of mother, not ruled out (O26.-, O35.-, O36.-, O40.-, O41.-)”

Referenced by Excludes2 notes

  • O98 — Maternal infectious and parasitic diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium [Excludes2](via O35.-): “when the reason for maternal care is that the disease is known or suspected to have affected the fetus (O35-O36)”
  • O99 — Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium [Excludes2](via O35.-): “when the reason for maternal care is that the condition is known or suspected to have affected the fetus (O35-O36)”

Clinical classification (CCSR)

  • PRG013 — Maternal care related to fetal conditions [CCSR]

Potential MS-DRG

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

Nearest codes (40)

  • O35 — Maternal care for known or suspected fetal abnormality and damage [Sibling]
  • O35.03X2 — Maternal care for (suspected) central nervous system malformation or damage in fetus, choroid plexus cysts, fetus 2 [Sibling]
  • O35.03X3 — Maternal care for (suspected) central nervous system malformation or damage in fetus, choroid plexus cysts, fetus 3 [Sibling]
  • O35.03X4 — Maternal care for (suspected) central nervous system malformation or damage in fetus, choroid plexus cysts, fetus 4 [Sibling]
  • O35.03X5 — Maternal care for (suspected) central nervous system malformation or damage in fetus, choroid plexus cysts, fetus 5 [Sibling]
  • O35.03X9 — Maternal care for (suspected) central nervous system malformation or damage in fetus, choroid plexus cysts, other fetus [Sibling]
  • O35.04 — Maternal care for (suspected) central nervous system malformation or damage in fetus, encephalocele [Sibling]
  • O35.04X0 — Maternal care for (suspected) central nervous system malformation or damage in fetus, encephalocele, not applicable or unspecified [Sibling]
  • and 32 more

Change history

  • FY2023 — Added to the code set [Change history]

Referenced by Other Codes

Clinical classification (AHRQ CCSR):PRG013 — Maternal care related to fetal conditions (default).

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

Potential MS-DRG Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

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.

Official ICD-10-CM tabular notes on other codes that name O35.05X9 or its code family.

1 Excludes1 notes: Z03.7 (via O35.-).

2 Excludes2 notes: O98 (via O35.-), O99 (via O35.-).

Frequently Asked Questions (FAQ) & Clinical Guidance

Does O35.05X9 require a 7th character?

Yes. One of the following 7th characters is to be assigned to each code under category O35. 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 O35 that has a 7th character of 1 through 9..

Nearest Codes in This Family

Official ICD-10-CM classifications closest to O35.05X9 in its code family, with their registry titles.

  • O35.05X1 — Maternal care for (suspected) central nervous system malformation or damage in fetus, holoprosencephaly, fetus 1
  • O35.05X2 — Maternal care for (suspected) central nervous system malformation or damage in fetus, holoprosencephaly, fetus 2
  • O35.05X3 — Maternal care for (suspected) central nervous system malformation or damage in fetus, holoprosencephaly, fetus 3
  • O35.05X4 — Maternal care for (suspected) central nervous system malformation or damage in fetus, holoprosencephaly, fetus 4
  • O35.05X5 — Maternal care for (suspected) central nervous system malformation or damage in fetus, holoprosencephaly, fetus 5
  • O35.06 — Maternal care for (suspected) central nervous system malformation or damage in fetus, hydrocephaly
  • O35.06X0 — Maternal care for (suspected) central nervous system malformation or damage in fetus, hydrocephaly, not applicable or unspecified
  • O35.06X1 — Maternal care for (suspected) central nervous system malformation or damage in fetus, hydrocephaly, fetus 1
  • O35.06X2 — Maternal care for (suspected) central nervous system malformation or damage in fetus, hydrocephaly, fetus 2
  • O35.06X3 — Maternal care for (suspected) central nervous system malformation or damage in fetus, hydrocephaly, fetus 3

View all codes in the O35 family