Is O69.5 a billable ICD-10-CM code?

No. O69.5 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does O69.5 sit in the tabular list?

Pregnancy, childbirth and the puerperium (O00-O9A), in the block Complications of labor and delivery (O60-O77).

O69.5

O69.5 — Labor and delivery complicated by vascular lesion of cord

Non-billable headerICD-10-CM

O69.5 is a non-billable header ICD-10-CM code for labor and delivery complicated by vascular lesion of cord. 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 O69. 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 O69 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.

Labor and delivery complicated by cord bruising
Labor and delivery complicated by cord hematoma
Labor and delivery complicated by thrombosis of umbilical vessels

Risk adjustment

O69.5 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.

How O69.5 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to O69.5.

Bruise›umbilical cord
Hematoma›umbilical cord, complicating delivery
Thrombosis, thrombotic›umbilical cord, complicating delivery(vessels)
Lesion›vascular›umbilical cord, complicating delivery
Hemorrhage, hemorrhagic›umbilicus, umbilical›cord›complicating delivery
Delivery›complicated›by›cord›bruising
Delivery›complicated›by›cord›hematoma
Delivery›complicated›by›cord›thrombosis(vessels)
Delivery›complicated›by›cord›vascular lesion

Code to one of these instead O69.5

7 child codes. Green means billable.

Related codes at this level

Codes that share O69. If O69.5 is not quite right, the correct code is usually one of these.

Questions about O69.5

Is O69.5 a billable ICD-10-CM code?: No. O69.5 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does O69.5 sit in the tabular list?: Pregnancy, childbirth and the puerperium (O00-O9A), in the block Complications of labor and delivery (O60-O77).