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ICD-10/O36.20X1

O36.20X1 ICD-10-CM Code: Maternal care for hydrops fetalis, unspecified trimester, fetus 1

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 hydrops fetalis, unspecified trimester, fetus 1 is a billable ICD-10-CM diagnosis code (O36.201).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for O36.20X1 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 of 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.

Change history

No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.

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 O36.20X1 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]
  • O36 — Clinical Diagnosis [Hierarchy]
  • O36.2 — Clinical Diagnosis [Hierarchy]
  • O36.20 — Clinical Diagnosis [Hierarchy]
  • O36.20X — Clinical Diagnosis [Hierarchy]

Referenced by Excludes1 notes

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

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)”

MDC crossing · procedures (94)

  • 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.”
  • 0U570ZZ — Destruction of Bilateral Fallopian Tubes, Open Approach [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Open Approach — grouped in MDC 14, the procedure side of this code's crossing.”
  • 0U573ZZ — Destruction of Bilateral Fallopian Tubes, Percutaneous Approach [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Percutaneous Approach — grouped in MDC 14, the procedure side of this code's crossing.”
  • 0U574ZZ — Destruction of Bilateral Fallopian Tubes, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Percutaneous Endoscopic Approach — grouped in MDC 14, the procedure side of this code's crossing.”
  • 0U577ZZ — Destruction of Bilateral Fallopian Tubes, Via Natural or Artificial Opening [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Via Natural or Artificial Opening — grouped in MDC 14, the procedure side of this code's crossing.”
  • 0U578ZZ — Destruction of Bilateral Fallopian Tubes, Via Natural or Artificial Opening Endoscopic [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Via Natural or Artificial Opening Endoscopic — grouped in MDC 14, the procedure side of this code's crossing.”
  • and 89 more

Nearest codes (40)

  • O36 — Maternal care for other fetal problems [Sibling]
  • O36.1929 — Maternal care for other isoimmunization, second trimester, other fetus [Sibling]
  • O36.193 — Maternal care for other isoimmunization, third trimester [Sibling]
  • O36.1930 — Maternal care for other isoimmunization, third trimester, not applicable or unspecified [Sibling]
  • O36.1931 — Maternal care for other isoimmunization, third trimester, fetus 1 [Sibling]
  • O36.1932 — Maternal care for other isoimmunization, third trimester, fetus 2 [Sibling]
  • O36.1933 — Maternal care for other isoimmunization, third trimester, fetus 3 [Sibling]
  • O36.1934 — Maternal care for other isoimmunization, third trimester, fetus 4 [Sibling]
  • and 32 more

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 O36.20X1 or its code family.

1 Excludes1 notes: Z03.7 (via O36.-).

Frequently Asked Questions (FAQ) & Clinical Guidance

Does O36.20X1 require a 7th character?

Yes. One 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..

Nearest Codes in This Family

Official ICD-10-CM classifications closest to O36.20X1 in its code family, with their registry titles.

  • O36.1995 — Maternal care for other isoimmunization, unspecified trimester, fetus 5
  • O36.1999 — Maternal care for other isoimmunization, unspecified trimester, other fetus
  • O36.2 — Maternal care for hydrops fetalis
  • O36.20 — Maternal care for hydrops fetalis, unspecified trimester
  • O36.20X0 — Maternal care for hydrops fetalis, unspecified trimester, not applicable or unspecified
  • O36.20X2 — Maternal care for hydrops fetalis, unspecified trimester, fetus 2
  • O36.20X3 — Maternal care for hydrops fetalis, unspecified trimester, fetus 3
  • O36.20X4 — Maternal care for hydrops fetalis, unspecified trimester, fetus 4
  • O36.20X5 — Maternal care for hydrops fetalis, unspecified trimester, fetus 5
  • O36.20X9 — Maternal care for hydrops fetalis, unspecified trimester, other fetus

View all codes in the O36 family