Is O36.8215 a billable ICD-10-CM code?

Yes. O36.8215 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does O36.8215 sit in the tabular list?

Pregnancy, childbirth and the puerperium (O00-O9A), in the block Maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48).

What cannot be coded together with O36.8215?

O36.8215 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above O36.8215 (O36) and apply to it just the same.

O36.8215

O36.8215 — Fetal anemia and thrombocytopenia, first trimester, fetus 5

Billable / specific codeICD-10-CM

O36.8215 is a billable, specific ICD-10-CM code for fetal anemia and thrombocytopenia, first trimester, fetus 5. It is valid for submission on a claim.

7th character "5" — fetus 5

One of the following 7th characters is to be assigned to each code under category O36. 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 O36 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

Excludes1 inherited from the categories above O36.8215

These are not written on O36.8215, but they bind it: a note on a category applies to every code beneath it. Billing O36.8215 with anything listed here is a denial.

Written on O36 — Maternal care for other fetal problems

encounter for suspected maternal and fetal conditions ruled out (Z03.7-)
placental transfusion syndromes (O43.0-)

Excludes2 inherited from the categories above O36.8215

Also inherited, and the opposite of Excludes1: these conditions are not part of O36.8215, but a patient can have both, so you may code both.

Written on O36 — Maternal care for other fetal problems

labor and delivery complicated by fetal stress (O77.-)

Other codes that can never be billed with O36.8215

These codes carry an Excludes1 note pointing at O36.8215. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading O36.8215 alone.

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

Risk adjustment

O36.8215 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code history

O36.8215 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share O36.821. If O36.8215 is not quite right, the correct code is usually one of these.

Questions about O36.8215

Is O36.8215 a billable ICD-10-CM code?: Yes. O36.8215 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does O36.8215 sit in the tabular list?: Pregnancy, childbirth and the puerperium (O00-O9A), in the block Maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48).
What cannot be coded together with O36.8215?: O36.8215 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above O36.8215 (O36) and apply to it just the same.