ICD-10-CM Code O35.0XX1

Maternal care for (suspected) central nervous system malformation in fetus, fetus 1

Version 2020 Billable Code Maternity Diagnoses Diagnoses For Females Only

Valid for Submission

O35.0XX1 is a billable code used to specify a medical diagnosis of maternal care for (suspected) central nervous system malformation in fetus, fetus 1. The code is valid for the year 2020 for the submission of HIPAA-covered transactions.

The code O35.0XX1 is applicable to female patients aged 12 through 55 years inclusive. It is clinically and virtually impossible to use this code on a non-female patient outside the stated age range.

ICD-10:O35.0XX1
Short Description:Maternal care for (suspected) cnsl malform in fetus, fetus 1
Long Description:Maternal care for (suspected) central nervous system malformation in fetus, fetus 1

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:

  • Maternity diagnoses - Maternity. Age range is 12–55 years inclusive (e.g., diabetes in pregnancy, antepartum pulmonary complication).
  • Diagnoses for females only - Medicare Code Editor detects inconsistencies between a patient’s sex and any diagnosis on the patient’s record, this code applies to FEMALES only .

Diagnostic Related Groups

The ICD-10 code O35.0XX1 is grouped in the following groups for version MS-DRG V37.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC).
applicable from 10/01/2019 through 09/30/2020.

  • 817 - OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURE WITH MCC
  • 818 - OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURE WITH CC
  • 819 - OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURE WITHOUT CC/MCC

Convert O35.0XX1 to ICD-9

  • 655.01 - Fetal cns malform-deliv (Approximate Flag)
  • 655.03 - Fetal cns malfor-antepar (Approximate Flag)

Code Classification

  • Pregnancy, childbirth and the puerperium (O00–O99)
    • Maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)
      • Maternal care for known or suspected fetal abnlt and damage (O35)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Information for Patients


Birth Defects

A birth defect is a problem that happens while a baby is developing in the mother's body. Most birth defects happen during the first 3 months of pregnancy. One out of every 33 babies in the United States is born with a birth defect.

A birth defect may affect how the body looks, works or both. Some birth defects like cleft lip or neural tube defects are structural problems that can be easy to see. To find others, like heart defects, doctors use special tests. Birth defects can range from mild to severe. Causes can include

  • Genetics
  • Exposures to medicines or chemicals. For example, alcohol abuse can cause fetal alcohol syndrome.
  • Infections during pregnancy
  • Certain medicines. Before you get pregnant, talk to your health care provider about any medicines you take.
  • Not getting enough of certain nutrients. For example, not getting enough folic acid before and during pregnancy is a key factor in causing neural tube defects.

For most birth defects, the cause is unknown.

Health care providers can diagnose certain birth defects during pregnancy, with prenatal tests. That's why it important to get regular prenatal care. Other birth defects may not be found until after the baby is born. Sometimes the defect is obvious right away. Other times, the health care provider may not discover it until later in life.

Babies with birth defects often need special care and treatments. The treatments may include surgery, medicines, assistive devices, and therapies.

Centers for Disease Control and Prevention


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Fetal Health and Development

A normal pregnancy lasts nine months. Each three-month period of pregnancy is called a trimester. During each trimester, the fetus grows and develops. Regular medical checkups and prenatal tests are very important. They can

  • Help keep you and your baby healthy
  • Spot problems with your baby (if there are any). In some cases, health care professionals can treat the problem before your baby is born. But even when they cannot, it can still be helpful to know about the problem early on. That gives you time to learn about your baby's condition and prepare for any challenges you may face after the baby is born.
  • Prevent problems during delivery. For example, if your baby is breech (bottom first or feet first, instead of head first), you may need to have a Cesarean section to avoid complications.

Besides getting medical care, there are other things you can do to keep your baby as healthy as possible. It's important not to drink or smoke. Try to eat a healthy diet and make sure to take care of any health problems you have during pregnancy.


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Health Problems in Pregnancy

Every pregnancy has some risk of problems. You may have problems because of a health condition you had before you got pregnant. You could also develop a condition during pregnancy. Other causes of problems during pregnancy can include being pregnant with more than one baby, a health problem in a previous pregnancy, substance abuse during pregnancy, or being over age 35. Any of these can affect your health, the health of your baby, or both.

If you have a chronic condition, you should talk to your health care provider about how to minimize your risk before you get pregnant. Once you are pregnant, you may need a health care team to monitor your pregnancy. Some common conditions that can complicate a pregnancy include

  • High blood pressure
  • Polycystic ovary syndrome
  • Kidney problems
  • Autoimmune disorders
  • Obesity
  • HIV/AIDS
  • Cancer
  • Infections

Other conditions that can make pregnancy risky can happen while you are pregnant - for example, gestational diabetes and Rh incompatibility. Good prenatal care can help detect and treat them.

Some discomforts, like nausea, back pain, and fatigue, are common during pregnancy. Sometimes it is hard to know what is normal. Call your health care provider if something is bothering or worrying you.


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