2026 ICD-10-CM Diagnosis Code O36.91X1Maternal care for fetal problem, unspecified, first trimester, fetus 1

ICD-10-CM Codes›O00-O9A›O30-O48›O36

ICD-10-CM O36.91X1
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

O36.91X1 is a billable ICD-10-CM diagnosis code for maternal care for fetal problem, unspecified, first trimester, fetus 1. The 7th character 1 identifies fetus 1 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). In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Maternal care related to fetal conditions.

Code Identity

ICD-10-CM Code
O36.91X1
Billable Status
Yes — Valid for Submission
Code Describes
Maternal care for fetal problem, unspecified, first trimester, fetus 1
Short Description
Maternal care for fetal problem, unsp, first tri, fetus 1
Parent Code
O36.91
Maternal care for fetal problem, unspecified, first trimester

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 CodeO36.91X1Maternal care for fetal problem, unspecified, first trimester, fetus 1

Code EditsBilling

Medicare Code Editor checks that affect claim validity for O36.91X1.

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).

Clinical ClassificationClinical

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

CCSR PRG013
Maternal care related to fetal conditions
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Health Problems in Pregnancy

A health problem in pregnancy is any disease or condition that could affect your health or the health of your fetus. Some health problems may make it more likely that you will have a high-risk pregnancy. A high-risk pregnancy is one in which you, your fetus, or both are at higher risk for health problems than in a typical pregnancy.

The full article covers:

  • What are health problems in pregnancy?
  • What raises my risk for health problems during pregnancy?
  • Can chronic health conditions cause problems in pregnancy?
  • Can health problems in pregnancy be prevented?

Read the full article at MedlinePlus

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

Convert O36.91X1 to ICD-9-CMHistory

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

ICD-9-CM
656.91 Fet/plac prob NOS-deliv
Approximate The match is approximate rather than exact.
ICD-9-CM
656.93 Fet/plac prob NOS-antepa
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 O36.91X1Overview

Is O36.91X1 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report maternal care for fetal problem, unspecified, first trimester, fetus 1 on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character 1 in O36.91X1 mean?

The final character 1 identifies the fetus in a multiple gestation pregnancy: this code reports maternal care for fetal problem, unspecified, first trimester for fetus 1.

What MS-DRG does O36.91X1 group to?

When maternal care for fetal problem, unspecified, first trimester, fetus 1 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 O36.91X1 be reported for?

The Medicare Code Editor checks maternal care for fetal problem, unspecified, first trimester, fetus 1 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 O36.91X1?

Under the General Equivalence Mappings, maternal care for fetal problem, unspecified, first trimester, fetus 1 converts to ICD-9-CM 656.91 (fet/plac prob NOS-deliv) and 656.93 (fet/plac prob NOS-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.