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O76 ICD-10-CM Code: Abnormality in fetal heart rate and rhythm complicating labor and delivery

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
7 inclusion terms · 3 Excludes1 · 2 Excludes2

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 O76 in the official ICD-10-CM tabular list, quoted as published.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Depressed fetal heart rate tones complicating labor and delivery
  • Fetal bradycardia complicating labor and delivery
  • Fetal heart rate decelerations complicating labor and delivery
  • Fetal heart rate irregularity complicating labor and delivery
  • Fetal heart rate abnormal variability complicating labor and delivery
  • Fetal tachycardia complicating labor and delivery
  • Non-reassuring fetal heart rate or rhythm complicating labor and 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).

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Coder workflow for O76

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

Before you code O76

  1. 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 →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with O76. 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 O76’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.

    ReviewO77.9, O77.8

Consider O76. 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).
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).

Official instructions as workflow

  • Excludes1 — check before selecting O76(3 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with O76: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareO77.9, O77.8

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

  • Excludes2 — not part of O76(2 notes)

    Coding workflow: The conditions named in this note are not included in O76. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareO68

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

Coding decision scenarios

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

Documentation: Both the condition O76 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).

ReviewO77.9, O77.8

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

Abnormality in fetal heart rate and rhythm complicating labor and delivery is a billable ICD-10-CM diagnosis code (O76).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (2)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

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

Other codes that name O76 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 2 Excludes1 notes: O77.8 — Labor and delivery complicated by other evidence of fetal stress, O77.9 — Labor and delivery complicated by fetal stress, unspecified.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 1 Excludes2 note: O68 — Labor and delivery complicated by abnormality of fetal acid-base balance.

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

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):PRG023 — Complications specified during childbirth (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 (Complications specified during childbirth).

O75.0 — Maternal distress during labor and delivery, O75.1 — Shock during or following labor and delivery, O75.2 — Pyrexia during labor, not elsewhere classified, O75.3 — Other infection during labor, O75.4 — Other complications of obstetric surgery and procedures, O75.5 — Delayed delivery after artificial rupture of membranes, O75.81 — Maternal exhaustion complicating labor and delivery, O75.82 — Onset (spontaneous) of labor after 37 completed weeks of gestation but before 39 completed weeks gestation, with delivery by (planned) cesarean section, O75.89 — Other specified complications of labor and delivery, O75.9 — Complication of labor and delivery, unspecified, O77.0 — Labor and delivery complicated by meconium in amniotic fluid, O82 — Encounter for cesarean delivery without indication, O86.0 — Infection of obstetric surgical wound, O86.00 — Infection of obstetric surgical wound, unspecified, O86.01 — Infection of obstetric surgical wound, superficial incisional site, O86.02 — Infection of obstetric surgical wound, deep incisional site, O86.03 — Infection of obstetric surgical wound, organ and space site, O86.04 — Sepsis following an obstetrical procedure, O86.09 — Infection of obstetric surgical wound, other surgical site, O88.02 — Air embolism in childbirth, +91 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Delivery”; these codes share that main term but sit in a different category of the Tabular List.

O72.2 — Delayed and secondary postpartum hemorrhage (complicated, by, retention of secundines, partial), O73.0 — Retained placenta without hemorrhage (complicated, by, adherent placenta, without hemorrhage), O73.1 — Retained portions of placenta and membranes, without hemorrhage (complicated, by, retention of secundines, partial, without hemorrhage), O74.8 — Other complications of anesthesia during labor and delivery (complicated, by, anesthetic death), O75.1 — Shock during or following labor and delivery (complicated, by, shock), O75.2 — Pyrexia during labor, not elsewhere classified (complicated, by, fever during labor), O75.5 — Delayed delivery after artificial rupture of membranes (delayed NOS, following rupture of membranes, artificial), O75.82 — Onset (spontaneous) of labor after 37 completed weeks of gestation but before 39 completed weeks gestation, with delivery by (planned) cesarean section (cesarean, occurring after 37 completed weeks of gestation but before 39 completed weeks gestation due toonset of labor), O75.89 — Other specified complications of labor and delivery (complicated, specified complication NEC), O75.9 — Complication of labor and delivery, unspecified (complicated), O77.0 — Labor and delivery complicated by meconium in amniotic fluid (complicated, by, meconium in amniotic fluid), O77.1 — Fetal stress in labor or delivery due to drug administration (complicated, by, fetal, stress, due to drug administration), O77.8 — Labor and delivery complicated by other evidence of fetal stress (complicated, by, fetal, hypoxia), O77.9 — Labor and delivery complicated by fetal stress, unspecified (complicated, by, fetal, stress), O80 — Encounter for full-term uncomplicated delivery (normal), O82 — Encounter for cesarean delivery without indication (cesarean, without indication), O98.02 — Tuberculosis complicating childbirth (complicated, by, tuberculosis), O98.12 — Syphilis complicating childbirth (complicated, by, syphilis), O98.22 — Gonorrhea complicating childbirth (complicated, by, gonorrhea), O98.32 — Other infections with a predominantly sexual mode of transmission complicating childbirth (complicated, by, infection, sexually transmitted NEC), +177 more

Contextual Map

Every relationship of O76 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.

Run O76 with these 5 related codes in Claim Check

Hierarchy

Excludes1

Excludes2

Referenced by Excludes1 notes

Referenced by Excludes2 notes

Clinical classification (CCSR)

MS-DRG Grouper

Index entries

  • Delivery (childbirth) (labor), complicated, by, depressed fetal heart tones[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Delivery (childbirth) (labor), complicated, by, fetal, heart rate or rhythm (abnormal) (non-reassuring)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

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
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
    Abnormality in fetal heart rate and rhythm complicating labor and delivery

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.