2026 ICD-10-CM Diagnosis Code Z37.4Twins, both stillborn

ICD-10-CM Codes›Z00–Z99›Z30-Z39›Z37

ICD-10-CM Z37.4
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z37.4 is a billable ICD-10-CM diagnosis code for twins, both stillborn. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 796 through 798, 805 through 807. The code is restricted by the Medicare Code Editor to maternity cases (age 9 through 64), not accepted as a principal diagnosis, and exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Maternal outcome of delivery.

Code Identity

ICD-10-CM Code
Z37.4
Billable Status
Yes — Valid for Submission
Code Describes
Twins, both stillborn
Short Description
Twins, both stillborn
Same as the full description in the CMS dataset.
Parent Code
Z37
Outcome of delivery

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionZ30-Z39Persons encountering health services in circumstances related to reproduction
CategoryZ37Outcome of delivery
This CodeZ37.4Twins, both stillborn

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z37.4.

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.
Outcome of delivery diagnoses codes
Outcome of delivery diagnoses codes.

Present on Admission (POA)Billing

Z37.4 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Premature birth of fraternal twins, both stillborn
  • Premature birth of identical twins, both stillborn
  • Premature birth of stillborn twins
  • Term birth of fraternal twins, both stillborn
  • Term birth of identical twins, both stillborn
  • Term birth of stillborn twins
  • Twins - both stillborn

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Outcome of delivery
      • twins NEC
        • both stillborn

Clinical ClassificationClinical

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

CCSR PRG030
Maternal outcome of delivery
Default principal diagnosis: inpatient No · outpatient Yes

Patient EducationClinical

Stillbirth

If you lose a fetus at or after the 20th week of pregnancy, it's called a stillbirth. A stillbirth can occur before or during delivery and may be considered as:

The full article covers:

  • What is a stillbirth?
  • What are the risk factors for stillbirth?
  • What are the possible causes of stillbirth?
  • How is a stillbirth diagnosed?
  • How do health care providers manage a stillbirth?

Read the full article at MedlinePlus

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

Convert Z37.4 to ICD-9-CMHistory

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

ICD-9-CM
V27.4 Deliver-twins, both sb
Exact Match The mapping is direct, with no qualifiers.

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 Z37.4Overview

Is Z37.4 (Outcome of delivery) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report twins, both stillborn on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does Z37.4 group to?

On inpatient claims, twins, both stillborn maps to MS-DRG 796, 797, 798, 805, 806, 807, with relative weights from 0.6742 to 1.1670 depending on complications. Higher weights mean higher Medicare reimbursement.

Can Z37.4 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because twins, both stillborn describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Who can Z37.4 be reported for?

The Medicare Code Editor checks twins, both stillborn against patient demographics: this code is intended for maternity cases (age 9 through 64). Claims outside these limits are flagged as inconsistent.

Is Z37.4 exempt from POA reporting?

Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for twins, both stillborn on inpatient claims.