2026 ICD-10-CM Diagnosis Code O35.5XX0Maternal care for (suspected) damage to fetus by drugs, not applicable or unspecified
O35.5XX0 is a billable ICD-10-CM diagnosis code for maternal care for (suspected) damage to fetus by drugs, 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). In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Maternal care related to fetal conditions and Other specified substance-related disorders.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for O35.5XX0.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Embryopathy caused by acitretin
- Fetal aminopterin syndrome
- Fetal anomaly caused by antihypertensive drug
- Fetal diethylstilbestrol syndrome
- Fetal disorder caused by antibacterial transmitted via placenta
- Fetal disorder caused by anticoagulant via placental transfer
- Fetal disorder caused by anticonvulsant via placental transfer
- Fetal disorder caused by anti-infective agent transmitted via placenta
- Fetal disorder caused by antineoplastic agent transmitted via placenta
- Fetal disorder caused by diethylstilbestrol transmitted via placenta
- Fetal disorder caused by drug or medicament
- Fetal disorder caused by endocrine agent via placental transfer
- Fetal disorder caused by hallucinogenic agent transmitted via placenta
- Fetal disorder caused by hypoglycemic agent via placental transfer
- Fetal disorder caused by immune serum transmitted via placenta
- Fetal disorder caused by maternal analgesia transmitted via placenta
- Fetal disorder caused by maternal analgesia transmitted via placenta during labor
- Fetal disorder caused by maternal anesthesia transmitted via placenta
- Fetal disorder caused by maternal anesthesia transmitted via placenta during labor
- Fetal disorder caused by maternal antihypertensive medication via placenta
- Fetal disorder caused by maternal general anesthesia transmitted via placenta
- Fetal disorder caused by maternal meperidine via placenta during labor
- Fetal disorder caused by maternal tranquilizer via placenta during labor
- Fetal disorder caused by medicinal agent transmitted via placenta
- Fetal disorder caused by narcotic transmitted via placenta
- Fetal disorder caused by uterine depressor via placental transfer
- Fetal disorder due to maternal epidural anesthesia during labor
- Fetal exposure to angiotensin converting enzyme inhibitor agent
- Fetal exposure to anticonvulsant
- Fetal exposure to drug
- Fetal exposure to methamphetamine
- Fetal trimethadione syndrome
- Propylthiouracil embryofetopathy
- Retinoid embryopathy
- Suspected fetal damage from maternal drug use
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Pregnancy and Substance Use
During pregnancy, there are many things you can do to keep yourself and your baby healthy. They include getting regular prenatal care, eating healthy, and staying active. But it's also very important to avoid substances that could be harmful to you and your baby, such as tobacco, alcohol, and drugs.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert O35.5XX0 to ICD-9-CMHistory
Code HistoryHistory
Questions About O35.5XX0Overview
Is O35.5XX0 (Maternal care for (suspected) damage to fetus by drugs) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report maternal care for (suspected) damage to fetus by drugs, not applicable or unspecified on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character 0 in O35.5XX0 mean?
The final character 0 shows the maternal care for (suspected) damage to fetus by drugs applies to a single gestation, or that the affected fetus cannot be identified.
What MS-DRG does O35.5XX0 group to?
When maternal care for (suspected) damage to fetus by drugs, 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 O35.5XX0 be reported for?
The Medicare Code Editor checks maternal care for (suspected) damage to fetus by drugs, 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 O35.5XX0?
Under the General Equivalence Mappings, maternal care for (suspected) damage to fetus by drugs, not applicable or unspecified converts to ICD-9-CM 655.51 (fet damag d/t drug-deliv) and 655.53 (fet damg d/t drug-antepa). 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.
