O40.9XX5 ICD-10-CM Code: Polyhydramnios, unspecified trimester, fetus 5
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
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for O40.9XX5 in the official ICD-10-CM tabular list.
Includes
Conditions the official ICD-10-CM tabular list includes under this code.
- hydramnios
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).
- encounter for suspected maternal and fetal conditions ruled out (Z03.7-) Compare O40.9XX5 vs Z03.7 →
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 O40.9XX5 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
- O40.9 — Polyhydramnios, unspecified trimester [Hierarchy]
Referenced by Excludes1 notes
- Z03.7 — Encounter for suspected maternal and fetal conditions ruled out [Excludes1](via O40.-): “known or suspected fetal anomalies affecting management of mother, not ruled out (O26.-, O35.-, O36.-, O40.-, O41.-)”
Clinical classification (CCSR)
- PRG014 — Polyhydramnios and other problems of amniotic cavity [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 (32)
- O40 — Polyhydramnios [Sibling]
- O40.1 — Polyhydramnios, first trimester [Sibling]
- O40.1XX0 — Polyhydramnios, first trimester, not applicable or unspecified [Sibling]
- O40.1XX1 — Polyhydramnios, first trimester, fetus 1 [Sibling]
- O40.1XX2 — Polyhydramnios, first trimester, fetus 2 [Sibling]
- O40.1XX3 — Polyhydramnios, first trimester, fetus 3 [Sibling]
- O40.1XX4 — Polyhydramnios, first trimester, fetus 4 [Sibling]
- O40.1XX5 — Polyhydramnios, first trimester, fetus 5 [Sibling]
- and 24 more
Referenced by Other Codes
Clinical classification (AHRQ CCSR):PRG014 — Polyhydramnios and other problems of amniotic cavity (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 O40.9XX5 or its code family.
1 Excludes1 notes: Z03.7 (via O40.-).
Frequently Asked Questions (FAQ) & Clinical Guidance
Does O40.9XX5 require a 7th character?
Yes. One of the following 7th characters is to be assigned to each code under category O40. 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 O40 that has a 7th character of 1 through 9..
Nearest Codes in This Family
Official ICD-10-CM classifications closest to O40.9XX5 in its code family, with their registry titles.
- O40.3XX4 — Polyhydramnios, third trimester, fetus 4
- O40.3XX5 — Polyhydramnios, third trimester, fetus 5
- O40.3XX9 — Polyhydramnios, third trimester, other fetus
- O40.9 — Polyhydramnios, unspecified trimester
- O40.9XX0 — Polyhydramnios, unspecified trimester, not applicable or unspecified
- O40.9XX1 — Polyhydramnios, unspecified trimester, fetus 1
- O40.9XX2 — Polyhydramnios, unspecified trimester, fetus 2
- O40.9XX3 — Polyhydramnios, unspecified trimester, fetus 3
- O40.9XX4 — Polyhydramnios, unspecified trimester, fetus 4
- O40.9XX9 — Polyhydramnios, unspecified trimester, other fetus