Is O36.8915 a billable ICD-10-CM code?

Yes. O36.8915 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does O36.8915 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).

O36.8915

O36.8915 — Maternal care for other specified fetal problems, first trimester, fetus 5

Billable / specific codeICD-10-CM

O36.8915 is a billable, specific ICD-10-CM code for maternal care for other specified fetal problems, 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

Risk adjustment

O36.8915 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.

Related codes at this level

Codes that share O36.891. If O36.8915 is not quite right, the correct code is usually one of these.

Questions about O36.8915

Is O36.8915 a billable ICD-10-CM code?: Yes. O36.8915 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does O36.8915 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).