O69.0XX0 ICD-10-CM Code: Labor and delivery complicated by prolapse of cord, not applicable or unspecified
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- 7th character
- Required — see the character table on this page
Inpatient Payment Groups (MS-DRG)
Potential MS-DRG participation — not a DRG assignment.
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.
- MS-DRG 998 — PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS (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.
7th Character Guide
"One of the following 7th characters is to be assigned to each code under category O69. 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 O69 that has a 7th character of 1 through 9."
- 0 — not applicable or unspecified (this page’s code)
- 1 — fetus 1
- 2 — fetus 2
- 3 — fetus 3
- 4 — fetus 4
- 5 — fetus 5
- 9 — other fetus
Variant codes in this family
O69.0XX0, O69.0XX1, O69.0XX2, O69.0XX3, O69.0XX4, O69.0XX5, O69.0XX9
Character meanings are CMS's official 7th-character extensions for this family, as carried in each variant code's official description; variant codes are registry rows. The explanation of how the encounter character is assigned is MedCoder editorial, distinct from the official content above it.
Coder workflow for O69.0XX0
MedCoder structured workflow — derived from this code’s own official record
Before you code O69.0XX0
- Unspecified does not mean incorrect. When the record gives no greater specificity, O69.0XX0 may be the appropriate code. Check the record for detail that supports a more specific sibling. An unspecified code is for records that do not provide the detail a more specific code needs; a query, not an assumption, is the route to specificity (Guidelines I.A.9.b, I.B.18).
See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →
- A 7th character is required in this family. Confirm the documentation supports the character assigned — its meaning in this family is defined in the official instruction. This page’s code carries “0”. The official 7th-character definitions for this family are quoted in the guide.
- Confirm the condition is documented as complicating the pregnancy, childbirth, or the puerperium, and check the trimester where the code carries one and the fetus character where the category requires it. Chapter 15 codes belong on the maternal record only and take sequencing priority over codes from other chapters. It is the provider’s responsibility to state that a condition is not affecting the pregnancy; the trimester is assigned from the documentation (Guidelines I.C.15.a, I.C.15.a.1, I.C.15.a.3).
Choose the right path
- Does the record document the detail a more specific sibling code needs?
Yes → Review the specific siblings in this subcategory.
No → Continue — O69.0XX0 is appropriate when the documentation goes no further. - Does the documentation support one of this family’s 7th-character values?
Yes → Assign the matching 7th character; the variant codes are in the 7th Character Guide.
No → The code is invalid without its 7th character — query for the missing element.
Consider O69.0XX0. Then confirm the code is valid for the date of service in the Verify section.
Documentation check
- The provider’s diagnostic statement
- Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
- 7th-character basis
- The documented element this family’s 7th character records (see the official definitions in the 7th Character Guide).
- Trimester
- Assigned from the documented trimester at the encounter, or the trimester in which the condition developed for inpatient stays (Guidelines I.C.15.a.3).
- Any detail beyond this code’s title
- What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.
Coding decision scenarios
Pattern scenarios for this code’s structure — decision rules, not clinical cases
Documentation: The provider documents the condition in the terms of this code’s title and records no further detail.
Coding question: Is a more specific sibling code supportable?
Path: Review the subcategory for a sibling that names the missing detail.
Reason: A more specific code needs documentation of the distinguishing element; without it the unspecified code is appropriate, and a provider query is the route to specificity (Guidelines I.A.9.b, I.B.18).
Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Official Coding Guidelines
Official source data — quoted verbatim from the CMS/NCHS Official Guidelines
Official source data — quoted verbatim from the CMS/NCHS Official Guidelines
Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.
Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A)
6) 7th character for fetus identification Where applicable, a 7th character is to be assigned for certain categories (O31, O32, O33.3 - O33.6, O35, O36, O40, O41, O60.1, O60.2, O64, and O69) to identify the fetus for which the complication code applies.
Verify Before Coding
- 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 in Claim Check.
Relationships & Classification
MedCoder structured relationships — computed from published CMS and AHRQ datasets
MS-DRG Grouper Relationships (FY2026)
Potential MS-DRG participation — not a DRG assignment.
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 1 MS-DRG: DRG 998 (MDC 14).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Clinical classification (AHRQ CCSR):PRG024 — Malposition, disproportion or other labor complications (default).
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Related Codes
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Malposition, disproportion or other labor complications).
O66.1 — Obstructed labor due to locked twins, O66.2 — Obstructed labor due to unusually large fetus, O66.3 — Obstructed labor due to other abnormalities of fetus, O66.40 — Failed trial of labor, unspecified, O66.41 — Failed attempted vaginal birth after previous cesarean delivery, O66.5 — Attempted application of vacuum extractor and forceps, O66.6 — Obstructed labor due to other multiple fetuses, O66.8 — Other specified obstructed labor, O66.9 — Obstructed labor, unspecified, O68 — Labor and delivery complicated by abnormality of fetal acid-base balance, O69.0XX1 — Labor and delivery complicated by prolapse of cord, fetus 1, O69.0XX2 — Labor and delivery complicated by prolapse of cord, fetus 2, O69.0XX3 — Labor and delivery complicated by prolapse of cord, fetus 3, O69.0XX4 — Labor and delivery complicated by prolapse of cord, fetus 4, O69.0XX5 — Labor and delivery complicated by prolapse of cord, fetus 5, O69.0XX9 — Labor and delivery complicated by prolapse of cord, other fetus, O69.1XX0 — Labor and delivery complicated by cord around neck, with compression, not applicable or unspecified, O69.1XX1 — Labor and delivery complicated by cord around neck, with compression, fetus 1, O69.1XX2 — Labor and delivery complicated by cord around neck, with compression, fetus 2, O69.1XX3 — Labor and delivery complicated by cord around neck, with compression, fetus 3, +239 more
Contextual Map
Every relationship of O69.0XX0 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]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O60-O77 — Complications of labor and delivery[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Clinical classification (CCSR)
- PRG024 — Malposition, disproportion or other labor complications[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
MS-DRG Grouper
- DRG 998 — PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS[MS-DRG]: “PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS (MDC 14)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
Nearest codes (40)
- O69 — Labor and delivery complicated by umbilical cord complications[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O69.0 — Labor and delivery complicated by prolapse of cord[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O69.0XX1 — Labor and delivery complicated by prolapse of cord, fetus 1[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O69.0XX2 — Labor and delivery complicated by prolapse of cord, fetus 2[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O69.0XX3 — Labor and delivery complicated by prolapse of cord, fetus 3[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O69.0XX4 — Labor and delivery complicated by prolapse of cord, fetus 4[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O69.0XX5 — Labor and delivery complicated by prolapse of cord, fetus 5[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- O69.0XX9 — Labor and delivery complicated by prolapse of cord, other fetus[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 32 more
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
Common coding questions
Does O69.0XX0 require a 7th character?
Yes. One of the following 7th characters is to be assigned to each code under category O69. 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 O69 that has a 7th character of 1 through 9..
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, title, tabular notes and index terms Official source data
- CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Coding guidelines Official source data
- ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
- Inpatient payment groups Official source data
- CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder structured relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionLabor and delivery complicated by prolapse of cord, not applicable or unspecified
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to O69.0XX0 in its code family, with their registry titles.
- O69 — Labor and delivery complicated by umbilical cord complications
- O69.0 — Labor and delivery complicated by prolapse of cord
- O69.0XX1 — Labor and delivery complicated by prolapse of cord, fetus 1
- O69.0XX2 — Labor and delivery complicated by prolapse of cord, fetus 2
- O69.0XX3 — Labor and delivery complicated by prolapse of cord, fetus 3
- O69.0XX4 — Labor and delivery complicated by prolapse of cord, fetus 4
- O69.0XX5 — Labor and delivery complicated by prolapse of cord, fetus 5
- O69.0XX9 — Labor and delivery complicated by prolapse of cord, other fetus
- O69.1 — Labor and delivery complicated by cord around neck, with compression
- O69.1XX0 — Labor and delivery complicated by cord around neck, with compression, not applicable or unspecified