O36.4 ICD-10-CM Code: Maternal care for intrauterine death
Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.
Official Registry Overview & Definition
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for O36.4 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
Inclusion Terms
Alternative terms the tabular list files under this code.
- Maternal care for intrauterine fetal death NOS
- Maternal care for intrauterine fetal death after completion of 20 weeks of gestation
- Maternal care for late fetal death
- Maternal care for missed delivery
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).
- missed abortion (O02.1) Compare O36.4 vs O02.1 →
- stillbirth (P95) Compare O36.4 vs P95 →
- encounter for suspected maternal and fetal conditions ruled out (Z03.7-) Compare O36.4 vs Z03.7 →
- placental transfusion syndromes (O43.0-) Compare O36.4 vs O43.0 →
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- labor and delivery complicated by fetal stress (O77.-) Compare O36.4 vs O77 →
Indexed Clinical Terms (10)
Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code.
- Dead, fetus, retained (mother)
- Delivery (childbirth) (labor), missed (at or near term)
- Missed, delivery
- Pregnancy (single) (uterine), complicated by (care of) (management affected by), death of fetus (near term)
- Pregnancy (single) (uterine), complicated by (care of) (management affected by), fetal (maternal care for), death (near term)
- Pregnancy (single) (uterine), complicated by (care of) (management affected by), fetal (maternal care for), intrauterine death
- Pregnancy (single) (uterine), complicated by (care of) (management affected by), intrauterine fetal death (near term)
- Pregnancy (single) (uterine), complicated by (care of) (management affected by), missed, delivery
- Retention, dead, fetus (at or near term) (mother)
- Retention, fetus, dead
Frequently Compared Codes
The official Excludes notes on O36.4 name these codes. Each comparison page covers when the two can — or must not — be reported together.
Change history
No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.
Verify Before Coding
- Not billable as written — a more specific code is required: O36.4XX0, O36.4XX1, O36.4XX2, O36.4XX3, O36.4XX4.
- Requires a 7th character. "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." Options: O36.4XX0, O36.4XX1, O36.4XX2, O36.4XX3, O36.4XX4, O36.4XX5
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.
Relationships & Classification
Official ICD-10-CM tabular notes on other codes that name O36.4 or its code family.
4 Excludes1 notes across 3 chapters: O02.1, P95, Z03.7 (via O36.-), Z33.2.
Contextual Map
Every relationship of O36.4 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]
Excludes1
- O02.1 — Missed abortion [Excludes1]: “missed abortion (O02.1)” · check together
- P95 — Stillbirth [Excludes1]: “stillbirth (P95)” · check together
Referenced by Excludes1 notes
- O02.1 — Missed abortion [Excludes1]: “fetal death (intrauterine) (late) (O36.4)” · check together
- P95 — Stillbirth [Excludes1]: “maternal care for intrauterine death (O36.4)” · check together
- 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.-)” · check together
- Z33.2 — Encounter for elective termination of pregnancy [Excludes1]: “late fetal death (O36.4)” · check together
Index entries (10)
- Dead, fetus, retained (mother)[Index term]
- Delivery (childbirth) (labor), missed (at or near term)[Index term]
- Missed, delivery[Index term]
- Pregnancy (single) (uterine), complicated by (care of) (management affected by), death of fetus (near term)[Index term]
- Pregnancy (single) (uterine), complicated by (care of) (management affected by), fetal (maternal care for), death (near term)[Index term]
- Pregnancy (single) (uterine), complicated by (care of) (management affected by), fetal (maternal care for), intrauterine death[Index term]
- Pregnancy (single) (uterine), complicated by (care of) (management affected by), intrauterine fetal death (near term)[Index term]
- Pregnancy (single) (uterine), complicated by (care of) (management affected by), missed, delivery[Index term]
- and 2 more
Nearest codes (40)
- O36 — Maternal care for other fetal problems [Sibling]
- O36.21X3 — Maternal care for hydrops fetalis, first trimester, fetus 3 [Sibling]
- O36.21X4 — Maternal care for hydrops fetalis, first trimester, fetus 4 [Sibling]
- O36.21X5 — Maternal care for hydrops fetalis, first trimester, fetus 5 [Sibling]
- O36.21X9 — Maternal care for hydrops fetalis, first trimester, other fetus [Sibling]
- O36.22 — Maternal care for hydrops fetalis, second trimester [Sibling]
- O36.22X0 — Maternal care for hydrops fetalis, second trimester, not applicable or unspecified [Sibling]
- O36.22X1 — Maternal care for hydrops fetalis, second trimester, fetus 1 [Sibling]
- and 32 more
Frequently Asked Questions (FAQ) & Clinical Guidance
Can O36.4 be billed directly?
No. O36.4 (Maternal care for intrauterine death) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.
Does O36.4 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 O36.4 in its code family, with their registry titles.
- O36.23X2 — Maternal care for hydrops fetalis, third trimester, fetus 2
- O36.23X3 — Maternal care for hydrops fetalis, third trimester, fetus 3
- O36.23X4 — Maternal care for hydrops fetalis, third trimester, fetus 4
- O36.23X5 — Maternal care for hydrops fetalis, third trimester, fetus 5
- O36.23X9 — Maternal care for hydrops fetalis, third trimester, other fetus
- O36.4XX0 — Maternal care for intrauterine death, not applicable or unspecified
- O36.4XX1 — Maternal care for intrauterine death, fetus 1
- O36.4XX2 — Maternal care for intrauterine death, fetus 2
- O36.4XX3 — Maternal care for intrauterine death, fetus 3
- O36.4XX4 — Maternal care for intrauterine death, fetus 4