2027 ICD-10-CM Diagnosis Code O64.4XX0Obstructed labor due to shoulder presentation, not applicable or unspecified
O64.4XX0 is a billable ICD-10-CM diagnosis code for obstructed labor due to shoulder presentation, 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 2027 (October 1, 2026 through September 30, 2027) 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 disorder due to shoulder presentation during labor. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Malposition, disproportion or other labor complications.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for O64.4XX0.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Fetal disorder due to shoulder presentation during labor
- Fetal dystocia
- Obstructed labor due to shoulder presentation
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to O64.4XX0: its own notes plus those printed at O64.4, O64, and Chapter 15. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
- supervision of normal pregnancy (Z34.-)
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code, if applicable, from category Z3A, Weeks of gestation, to identify the specific week of the pregnancy, if known.
Notes
General instructions on how these codes are used.
- CODES FROM THIS CHAPTER ARE FOR USE ONLY ON MATERNAL RECORDS, NEVER ON NEWBORN RECORDS
- Codes from this chapter are for use for conditions related to or aggravated by the pregnancy, childbirth, or by the puerperium (maternal causes or obstetric causes)
- Trimesters are counted from the first day of the last menstrual period. They are defined as follows:
- 1st trimester- less than 14 weeks 0 days
- 2nd trimester- 14 weeks 0 days to less than 28 weeks 0 days
- 3rd trimester- 28 weeks 0 days until delivery
7th Character
Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.
- One of the following 7th characters is to be assigned to each code under category O64. 7th character 0 is for single gestations and multiple gestations where the fetus is unspecified. 7th characters 1 through 9 are for cases of multiple gestations to identify the fetus for which the code applies. The appropriate code from category O30, Multiple gestation, must also be assigned when assigning a code from category O64 that has a 7th character of 1 through 9.
- 0not applicable or unspecified this code
- 1fetus 1
- 2fetus 2
- 3fetus 3
- 4fetus 4
- 5fetus 5
- 9other fetus
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name O64.4XX0, its category, or a range that includes it.
Applicable To 1
These notes mention O64.4XX0.
- P03.1 Newborn affected by other malpresentation, malposition and disproportion during labor and delivery
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Childbirth Problems
Childbirth is the process of giving birth to a baby. It includes labor and delivery. Usually everything goes well, but problems can happen. They may cause a risk to the mother, baby, or both. Some of the more common childbirth problems include:
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert O64.4XX0 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About O64.4XX0Overview
Is O64.4XX0 (Obstructed labor due to shoulder presentation) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report obstructed labor due to shoulder presentation, not applicable or unspecified on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character 0 in O64.4XX0 mean?
The final character 0 shows the obstructed labor due to shoulder presentation applies to a single gestation, or that the affected fetus cannot be identified.
What MS-DRG does O64.4XX0 group to?
When obstructed labor due to shoulder presentation, not applicable or unspecified is the principal diagnosis on an inpatient stay, it groups to MS-DRG 833, 832, 831, 819, 818, 817, with relative weights from 0.5000 to 1.7586 depending on complications. Higher weights mean higher Medicare reimbursement.
Who can O64.4XX0 be reported for?
The Medicare Code Editor checks obstructed labor due to shoulder presentation, 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.
Can O64.4XX0 be reported with O66.0?
Not as a rule. The Excludes1 note at O64.4, which applies to O64.4XX0, lists "impacted shoulders (O66.0)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
