Expanded ICD-10 O35 Series: Maternal care for known or suspected fetal abnormality and damage

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Authors: The Society for Maternal-Fetal Medicine (SMFM) Coding Committee; Stephen Bacak, DO, MPH, FACOG; Erin Kornovich CPC; Steve Rad, MD, FACOG.

Effective October 1, 2022, the code category 035 Maternal care for known or suspected fetal abnormality and damage were expanded in the areas of central nervous system, chromosomal, and other abnormalities to include more specific descriptions. It is important for MFM specialist to be aware of and implement these newer codes in their practice.

The new codes are listed below. As a reminder, this code category requires a 7^th character to indicate the fetus that is affected. A 7^th character of “0” is used to indicate a singleton pregnancy, “1-5” means twin 1-5, and “9” means a fetus from a multiple pregnancy greater than 5.

Maternal care for (suspected) central nervous system malformation or damage in the fetus:

1. O35.00X# Unspecified
2. O35.01X# Agenesis of the corpus callosum
3. O35.02X# Anencephaly
4. O35.03X# Choroid plexus cysts
5. O35.04X# Encephalocele
6. O35.05X# Holoprosencephaly
7. O35.06X# Hydrocephaly
8. O35.07X# Microcephaly
9. O35.08X# Spina bifida
10. O35.09X# Other central nervous system malformation or damage in fetus

Maternal care for (suspected) chromosomal abnormality in fetus:

1. O35.10X# Unspecified
2. O35.11X# Trisomy 13
3. O35.12X# Trisomy 18
4. O35.13X# Trisomy 21
5. O35.14X# Monosomy X/Turner Syndrome
6. O35.15X# Sex chromosome abnormality
   
7. O35.19X# Other chromosomal abnormality

Maternal care for other (suspected) fetal abnormality and damage:

1. O35.AXX# Fetal facial anomalies
2. O35.BXX# Fetal cardiac anomalies
3. O35.CXX# Fetal pulmonary anomalies
4. O35.DXX# Fetal gastrointestinal anomalies
5. O35.EXX# Fetal genitourinary anomalies
6. O35.FXX# Fetal musculoskeletal anomalies of trunk
7. O35.GXX# Fetal upper extremities anomalies
8. O35.HXX# Fetal lower extremities anomalies

Other maternal care for known or suspected fetal abnormality and damage:

1. O35.2XX# Hereditary disease in fetus
2. O35.3XX# Damage from maternal viral disease
3. O34.4XX# Damage from alcohol
4. O35.5XX# Damage by drugs
5. O35.6XX# Damage by radiation
6. O35.7XX# Damage by other medical procedures
7. O35.8XX# Other abnormality and damage, not included elsewhere
8. 035.9XX# Unspecified abnormality and damage

The SMFM Coding Committee website has an ICD 10 Cheat Sheet that can be referenced throughout your workday, and these newer codes are included. Furthermore, the Coding Committee also has a chart for ICD-10 indications for 76811 detailed ultrasound, including these newer codes. 

Members should submit any coding questions to the SMFM Coding Committee Ask a Coding Question website. Our coding website also provides additional information and resources. Thank you very much!