2026 ICD-10-CM Diagnosis Code O35.4XX0Maternal care for (suspected) damage to fetus from alcohol, not applicable or unspecified

ICD-10-CM Codes›O00-O9A›O30-O48›O35

ICD-10-CM O35.4XX0
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

O35.4XX0 is a billable ICD-10-CM diagnosis code for maternal care for (suspected) damage to fetus from alcohol, not applicable or unspecified. The 7th character 0 shows this applies to a single gestation, or that the affected fetus is not identified. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 817 through 819, 831 through 833. The code is restricted by the Medicare Code Editor to maternity cases (age 9 through 64). Coders also document this condition as fetal Alcohol Spectrum Disorder. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Alcohol-related disorders and Maternal care related to fetal conditions.

Code Identity

ICD-10-CM Code
O35.4XX0
Billable Status
Yes — Valid for Submission
Code Describes
Maternal care for (suspected) damage to fetus from alcohol, not applicable or unspecified
Short Description
Maternal care for damage to fetus from alcohol, unsp
Parent Code
O35.4
Maternal care for (suspected) damage to fetus from alcohol

Code Classification

ChapterO00-O9APregnancy, childbirth and the puerperium
SectionO30-O48Maternal care related to the fetus and amniotic cavity and possible delivery problems
CategoryO35Maternal care for known or suspected fetal abnormality and damage
This CodeO35.4XX0Maternal care for (suspected) damage to fetus from alcohol, not applicable or unspecified

Code EditsBilling

Medicare Code Editor checks that affect claim validity for O35.4XX0.

Maternity diagnoses
The Medicare Code Editor detects inconsistencies in maternity cases by checking a patient's age and any diagnosis on the patient's record. The maternity code edits apply to patients age ange is 9–64 years inclusive (e.g., diabetes in pregnancy, antepartum pulmonary complication).

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Fetal Alcohol Spectrum Disorder
  • Fetal disorder caused by maternal alcohol dependence in pregnancy
  • Fetal exposure to alcohol
  • Suspected fetal damage from maternal alcohol
  • Suspected fetal damage from maternal alcohol addiction
  • Suspected fetal damage from maternal drug use

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR MBD017
Alcohol-related disorders
Default principal diagnosis: inpatient No · outpatient No
CCSR PRG013
Maternal care related to fetal conditions
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Fetal Alcohol Spectrum Disorder

    a group of disorders caused by a prenatal exposure to maternal consumption of alcohol leading to a range of behavioral, cognitive and neurological deficits in the offspring. it is characterized by physical growth problems, distinct facies, and varying psycho-neurological issues.

Patient EducationClinical

Fetal Alcohol Spectrum Disorders

Alcohol can harm your baby at any stage during a pregnancy. That includes the earliest stages, before you even know you are pregnant. Drinking during pregnancy can cause a group of conditions called fetal alcohol spectrum disorders (FASDs).

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert O35.4XX0 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
655.41 Fet damg d/t dis-deliver
Approximate The match is approximate rather than exact.
ICD-9-CM
655.43 Fet damg d/t dis-antepar
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About O35.4XX0Overview

Is O35.4XX0 (Maternal care for (suspected) damage to fetus from alcohol) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report maternal care for (suspected) damage to fetus from alcohol, not applicable or unspecified on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character 0 in O35.4XX0 mean?

The final character 0 shows the maternal care for (suspected) damage to fetus from alcohol applies to a single gestation, or that the affected fetus cannot be identified.

What MS-DRG does O35.4XX0 group to?

When maternal care for (suspected) damage to fetus from alcohol, not applicable or unspecified is the principal diagnosis on an inpatient stay, it groups to MS-DRG 817, 818, 819, 831, 832, 833, with relative weights from 0.5229 to 1.6880 depending on complications. Higher weights mean higher Medicare reimbursement.

Who can O35.4XX0 be reported for?

The Medicare Code Editor checks maternal care for (suspected) damage to fetus from alcohol, not applicable or unspecified against patient demographics: this code is intended for maternity cases (age 9 through 64). Claims outside these limits are flagged as inconsistent.

What is the ICD-9 equivalent of O35.4XX0?

Under the General Equivalence Mappings, maternal care for (suspected) damage to fetus from alcohol, not applicable or unspecified converts to ICD-9-CM 655.41 (fet damg d/t dis-deliver) and 655.43 (fet damg d/t dis-antepar). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.