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O69.1XX3 ICD-10-CM Code: Labor and delivery complicated by cord around neck, with compression, fetus 3

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
Tabular directives
1 Excludes1

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.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for O69.1XX3 in the official ICD-10-CM tabular list, quoted as published.

Notes without a marker are published on O69.1XX3 itself; “inherited from” names the category or block whose note applies here.

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).

Source: inherited from O69.1

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
  • 1 — fetus 1
  • 2 — fetus 2
  • 3 — fetus 3 (this page’s code)
  • 4 — fetus 4
  • 5 — fetus 5
  • 9 — other fetus

Variant codes in this family

O69.1XX0, O69.1XX1, O69.1XX2, O69.1XX3, O69.1XX4, O69.1XX5, O69.1XX9

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 O69.1XX3

MedCoder structured workflow — derived from this code’s own official record

Before you code O69.1XX3

  1. 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 “3”. The official 7th-character definitions for this family are quoted in the guide.

    See the 7th Character Guide

  2. O69.1XX3’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

    Guide: Combination codes →

  3. 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).

    Guide: How to choose an ICD-10-CM code →

  4. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with O69.1XX3. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in O69.1XX3’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewO69.81

  2. 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 O69.1XX3. 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).
Fetus affected
For multiple gestations, the fetus the condition affects, as documented.
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).

Official instructions as workflow

  • Excludes1 — check before selecting O69.1XX3(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with O69.1XX3: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareO69.81

    See the official tabular notes · Guidelines I.A.12.a

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition O69.1XX3 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewO69.81

Documentation: Only one of the components this code’s title joins is documented.

Coding question: Is O69.1XX3 supported?

Path: Review the code for the documented component on its own.

Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).

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

Labor and delivery complicated by cord around neck, with compression, fetus 3 is a billable ICD-10-CM diagnosis code (O69.1XX3).

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).

O69.0XX0 — Labor and delivery complicated by prolapse of cord, not applicable or unspecified, 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, O69.1XX4 — Labor and delivery complicated by cord around neck, with compression, fetus 4, O69.1XX5 — Labor and delivery complicated by cord around neck, with compression, fetus 5, O69.1XX9 — Labor and delivery complicated by cord around neck, with compression, other fetus, O69.2XX0 — Labor and delivery complicated by other cord entanglement, with compression, not applicable or unspecified, O69.2XX1 — Labor and delivery complicated by other cord entanglement, with compression, fetus 1, O69.2XX2 — Labor and delivery complicated by other cord entanglement, with compression, fetus 2, O69.2XX3 — Labor and delivery complicated by other cord entanglement, with compression, fetus 3, O69.2XX4 — Labor and delivery complicated by other cord entanglement, with compression, fetus 4, O69.2XX5 — Labor and delivery complicated by other cord entanglement, with compression, fetus 5, O69.2XX9 — Labor and delivery complicated by other cord entanglement, with compression, other fetus, +239 more

Contextual Map

Every relationship of O69.1XX3 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

Clinical classification (CCSR)

MS-DRG Grouper

Nearest codes (40)

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 O69.1XX3 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, 2015
    In the code set at ICD-10-CM adoption
    Labor and delivery complicated by cord around neck, with compression, fetus 3

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 O69.1XX3 in its code family, with their registry titles.

View all codes in the O69 family