O35.3XX5

O35.3XX5: Maternal care for (suspected) damage to fetus from viral disease in mother, fetus 5

Billable / specific codeICD-10-CM

O35.3XX5 is a billable, specific ICD-10-CM code for maternal care for (suspected) damage to fetus from viral disease in mother, fetus 5. It is valid for submission on a claim.

Check O35.3XX5 with the rest of the claim: free scrubber

7th character "5": fetus 5

One of the following 7th characters is to be assigned to each code under category O35. 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 O35 that has a 7th character of 1 through 9.

0: not applicable or unspecified
1: fetus 1
2: fetus 2
3: fetus 3
4: fetus 4
5: fetus 5
9: other fetus

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Maternal care for damage to fetus from maternal cytomegalovirus infection
Maternal care for damage to fetus from maternal rubella

Excludes1 inherited from the categories above O35.3XX5

A category’s note binds every code beneath it.

Written on O35: Maternal care for known or suspected fetal abnormality and damage

encounter for suspected maternal and fetal conditions ruled out (Z03.7-)

Other codes that can never be billed with O35.3XX5

Their own Excludes1 notes name this code, so the conflict is not listed above.

Z03.7Encounter for suspected maternal and fetal conditions ruled out

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

O35.3XX5 is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A55326Billing and Coding: Zika Virus Testing by PCR and ELISA Methods

Code history

Unchanged in every release from FY2024 to FY2027.