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ICD-10/O64.4XX4

O64.4XX4 ICD-10-CM Code: Obstructed labor due to shoulder presentation, fetus 4

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 (FY2026), 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.

Code Set: Valid FY2026 and FY2027. FY2026 took effect October 1, 2025.

Official Registry Overview & Definition

Obstructed labor due to shoulder presentation, fetus 4 is a billable ICD-10-CM diagnosis code (O64.44).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for O64.4XX4 in the official ICD-10-CM tabular list.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Prolapsed arm

Excludes1 — Not Coded Here

Conditions that can never be reported with this code; the two are mutually exclusive.

  • impacted shoulders (O66.0)
  • shoulder dystocia (O66.0)

Frequently Asked Questions (FAQ) & Clinical Guidance

Does O64.4XX4 require a 7th character?

Yes. One of the following 7th characters is to be assigned to each code under category O64. 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 O64 that has a 7th character of 1 through 9..

Nearest Codes in This Family

Official ICD-10-CM classifications closest to O64.4XX4 in its code family, with their registry titles.

  • O64.4 — Obstructed labor due to shoulder presentation
  • O64.4XX0 — Obstructed labor due to shoulder presentation, not applicable or unspecified
  • O64.4XX1 — Obstructed labor due to shoulder presentation, fetus 1
  • O64.4XX2 — Obstructed labor due to shoulder presentation, fetus 2
  • O64.4XX3 — Obstructed labor due to shoulder presentation, fetus 3
  • O64.4XX5 — Obstructed labor due to shoulder presentation, fetus 5
  • O64.4XX9 — Obstructed labor due to shoulder presentation, other fetus
  • O64.5 — Obstructed labor due to compound presentation
  • O64.5XX0 — Obstructed labor due to compound presentation, not applicable or unspecified
  • O64.5XX1 — Obstructed labor due to compound presentation, fetus 1

View all codes in the O64 family