2026 ICD-10-CM Diagnosis Code O36.80X4Pregnancy with inconclusive fetal viability, fetus 4

ICD-10-CM Codes›O00-O9A›O30-O48›O36

ICD-10-CM O36.80X4
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

O36.80X4 is a billable ICD-10-CM diagnosis code for pregnancy with inconclusive fetal viability, fetus 4. The 7th character 4 identifies fetus 4 in a multiple gestation pregnancy. 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) and not accepted as a principal diagnosis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Maternal care related to fetal conditions.

Code Identity

ICD-10-CM Code
O36.80X4
Billable Status
Yes — Valid for Submission
Code Describes
Pregnancy with inconclusive fetal viability, fetus 4
Short Description
Pregnancy with inconclusive fetal viability, fetus 4
Same as the full description in the CMS dataset.
Parent Code
O36.80
Pregnancy with inconclusive fetal viability

Code Classification

ChapterO00-O9APregnancy, childbirth and the puerperium
SectionO30-O48Maternal care related to the fetus and amniotic cavity and possible delivery problems
CategoryO36Maternal care for other fetal problems
This CodeO36.80X4Pregnancy with inconclusive fetal viability, fetus 4

Code EditsBilling

Medicare Code Editor checks that affect claim validity for O36.80X4.

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).
Unacceptable principal diagnosis
There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Clinical ClassificationClinical

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

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

Convert O36.80X4 to ICD-9-CMHistory

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

ICD-9-CM
V23.87 Preg w incon fetl viabil
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 O36.80X4Overview

Is O36.80X4 (Pregnancy with inconclusive fetal viability) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report pregnancy with inconclusive fetal viability, fetus 4 on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character 4 in O36.80X4 mean?

The final character 4 identifies the fetus in a multiple gestation pregnancy: this code reports pregnancy with inconclusive fetal viability for fetus 4.

What MS-DRG does O36.80X4 group to?

On inpatient claims, pregnancy with inconclusive fetal viability, fetus 4 maps 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.

Can O36.80X4 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because pregnancy with inconclusive fetal viability, fetus 4 describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Who can O36.80X4 be reported for?

The Medicare Code Editor checks pregnancy with inconclusive fetal viability, fetus 4 against patient demographics: this code is intended for maternity cases (age 9 through 64). Claims outside these limits are flagged as inconsistent.

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.