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Z37.2 ICD-10-CM Code: Twins, both liveborn

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

Coding at a Glance

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 768 — VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C (MDC 14)
  • MS-DRG 796 — VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC (MDC 14)
  • MS-DRG 797 — VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC (MDC 14)
  • MS-DRG 798 — VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC (MDC 14)
  • MS-DRG 805 — VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC (MDC 14)
  • MS-DRG 806 — VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC (MDC 14)
  • MS-DRG 807 — VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC (MDC 14)
  • MS-DRG 951 — OTHER FACTORS INFLUENCING HEALTH STATUS (MDC 23)

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 Z37.2 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on Z37.2 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 Z37

Coder workflow for Z37.2

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

Before you code Z37.2

  1. Confirm the reason for the encounter this Z code records: the circumstance it records. Check whether the code may be reported as first-listed or principal — some Z codes are limited to one position — and do not report a history or status code for a condition documented as current. Z code categories and their reporting positions (Guidelines I.C.21.c, I.C.21.c.15).

    Guide: Z codes as principal or first-listed diagnosis →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with Z37.2. 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 Z37.2’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.

    ReviewP95

Consider Z37.2. 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).
The reason for the encounter
Whether the code records the encounter’s purpose, a status, or a history — and whether it may be first-listed (Guidelines I.C.21.c).

Official instructions as workflow

  • Excludes1 — check before selecting Z37.2(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with Z37.2: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareP95

    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 Z37.2 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).

ReviewP95

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

Twins, both liveborn is a billable ICD-10-CM diagnosis code (Z37.2).

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 (1)

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.

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)

5) Outcome of delivery A code from category Z37, Outcome of delivery, should be included on every maternal record when a delivery has occurred. These codes are not to be used on subsequent records or on the newborn record.

Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A)

1) Abortion with Liveborn Fetus When an attempted termination of pregnancy results in a liveborn fetus, assign code Z33.2, Encounter for elective termination of pregnancy and a code from category Z37, Outcome of Delivery.

Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)

The outcome of delivery, category Z37, should be included on all maternal delivery records. It is always a secondary code.

Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)

Codes in category Z37 should not be used on the newborn record.

Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)

Z codes/categories for obstetrical and reproductive services: Z30 Encounter for contraceptive management Z31 Encounter for procreative management Z32.2 Encounter for childbirth instruction Z32.3 Encounter for childcare instruction Z33 Pregnant state Z34 Encounter for supervision of normal pregnancy Z36 Encounter for antenatal screening of mother Z3A Weeks of gestation Z37 Outcome of delivery Z39 Encounter for maternal postpartum care and examination Z76.81 Expectant mother prebirth pediatrician visit

Verify Before Coding

  • Principal-diagnosis restriction. The Medicare Code Editor lists this code as unacceptable as a principal diagnosis: it describes a circumstance influencing health status rather than a current illness or injury being treated. It is valid as a secondary diagnosis.
  • 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.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 8 MS-DRGs: DRG 768 (MDC 14), DRG 796 (MDC 14), DRG 797 (MDC 14), DRG 798 (MDC 14), DRG 805 (MDC 14), DRG 806 (MDC 14), DRG 807 (MDC 14), DRG 951 (MDC 23).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):PRG030 — Maternal outcome of delivery (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

Principal diagnosis restriction (Medicare Code Editor)

Not acceptable as a principal diagnosis on an inpatient claim.

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Maternal outcome of delivery).

Z37.0 — Single live birth, Z37.1 — Single stillbirth, Z37.3 — Twins, one liveborn and one stillborn, Z37.4 — Twins, both stillborn, Z37.50 — Multiple births, unspecified, all liveborn, Z37.51 — Triplets, all liveborn, Z37.52 — Quadruplets, all liveborn, Z37.53 — Quintuplets, all liveborn, Z37.54 — Sextuplets, all liveborn, Z37.59 — Other multiple births, all liveborn, Z37.60 — Multiple births, unspecified, some liveborn, Z37.61 — Triplets, some liveborn, Z37.62 — Quadruplets, some liveborn, Z37.63 — Quintuplets, some liveborn, Z37.64 — Sextuplets, some liveborn, Z37.69 — Other multiple births, some liveborn, Z37.7 — Other multiple births, all stillborn, Z37.9 — Outcome of delivery, unspecified

Contextual Map

Every relationship of Z37.2 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

MDC crossing

  • MDC 14 — Pregnancy, Childbirth and the Puerperium[MDC crossing]: “Pregnancy, Childbirth and the Puerperium — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 94 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
  • MDC 23 — Factors Influencing Health Status and Other Contacts with Health Services[MDC crossing]: “Factors Influencing Health Status and Other Contacts with Health Services — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1,235 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Outcome of delivery, twins NEC, both liveborn[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (21)

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
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

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "Z37.2 — Twins, both liveborn." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/z37.2-twins-both-liveborn

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Twins, both liveborn

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 Z37.2 in its code family, with their registry titles.

View all codes in the Z37 family