ICD-10-CM Z37.54
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

Z37.54 is a billable ICD-10-CM diagnosis code for sextuplets, all liveborn. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 768, 796 through 798, 805 through 807, 951. 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. Coders also document this condition as premature birth of multiple newborns. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Maternal outcome of delivery.

Code Identity

ICD-10-CM Code
Z37.54
Billable Status
Yes — Valid for Submission
Code Describes
Sextuplets, all liveborn
Short Description
Sextuplets, all liveborn
Same as the full description in the CMS dataset.
Parent Code
Other multiple births, all liveborn

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 CodeZ37.54Sextuplets, all liveborn

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z37.54.

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).
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.

Present on Admission (POA)Billing

Z37.54 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Persons encountering health services in circumstances related to reproduction (Z30-Z39).

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Premature birth of multiple newborns
  • Premature birth of newborn sextuplets
  • Sextuplet birth
  • Sextuplets, all live born
  • Term birth of multiple newborns
  • Term birth of newborn sextuplets

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to Z37.54: its own notes plus those printed at Z37 and Chapter 21. 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.

From Z37 Outcome of delivery applies to 19 codes
  • stillbirth (P95)

Notes

General instructions on how these codes are used.

From Chapter 21 (Z00-Z99) Factors influencing health status and contact with health services applies to 1,425 codes
  • Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
  • (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
  • (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

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

Twins, Triplets, Multiple Births

If you are pregnant with more than one baby, you are far from alone. Multiple births are up in the United States. More women are having babies after age 30 and more are taking fertility drugs. Both boost the chance of carrying more than one baby. A family history of twins also makes multiples more likely.

Read the full article at MedlinePlus

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

Convert Z37.54 to ICD-9-CMHistory

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

ICD-9-CM
V27.5 Del-mult birth, all live
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 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About Z37.54Overview

What is the ICD-10 code for sextuplets, all liveborn?

The ICD-10-CM code for sextuplets, all liveborn is Z37.54 (sometimes written as Z3754). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is Z37.54 (Other multiple births, all liveborn) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report sextuplets, all liveborn on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does Z37.54 group to?

On inpatient claims, sextuplets, all liveborn maps to MS-DRG 798, 951, 797, 768, 805, 806, 796, 807, with relative weights from 0.5574 to 1.1809 depending on complications. Higher weights mean higher Medicare reimbursement.

Can Z37.54 be a principal diagnosis?

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

Who can Z37.54 be reported for?

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