Is O36.893 a billable ICD-10-CM code?

No. O36.893 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does O36.893 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).

O36.893

O36.893 — Maternal care for other specified fetal problems, third trimester

Non-billable headerICD-10-CM

O36.893 is a non-billable header ICD-10-CM code for maternal care for other specified fetal problems, third trimester. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

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

O36.893 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 to one of these instead O36.893

7 child codes. Green means billable.

Related codes at this level

Codes that share O36.89. If O36.893 is not quite right, the correct code is usually one of these.

Questions about O36.893

Is O36.893 a billable ICD-10-CM code?: No. O36.893 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does O36.893 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).