2026 ICD-10-CM Diagnosis Code Z38.5Twin liveborn infant, unspecified as to place of birth

ICD-10-CM CodesZ00–Z99Z30-Z39Z38

ICD-10-CM Z38.5
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z38.5 is a billable ICD-10-CM diagnosis code for twin liveborn infant, unspecified as to place of birth. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). The code is restricted by the Medicare Code Editor to newborn patients (age 0) and exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Liveborn.

Code Identity

ICD-10-CM Code
Z38.5
Billable Status
Yes — Valid for Submission
Code Describes
Twin liveborn infant, unspecified as to place of birth
Short Description
Twin liveborn infant, unspecified as to place of birth
Same as the full description in the CMS dataset.
Parent Code
Liveborn infants according to place of birth and type of delivery

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionZ30-Z39Persons encountering health services in circumstances related to reproduction
CategoryZ38Liveborn infants according to place of birth and type of delivery
This CodeZ38.5Twin liveborn infant, unspecified as to place of birth

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z38.5.

The Medicare Code Editor detects inconsistencies in perinatal / newborn cases by checking a patient's age and any diagnosis on the patient's record. The newborn code edits apply to patients age 0 years only; a subset of diagnoses which will only occur during the perinatal or newborn period of age 0 (e.g., tetanus neonatorum, health examination for newborn under 8 days old).

Present on Admission (POA)Billing

Z38.5 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

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.

    • Infant(s)
      • liveborn (singleton)
        • twin
    • Newborn(infant) (liveborn) (singleton)
      • twin

Clinical ClassificationClinical

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

CCSR PNL001
Liveborn
Default principal diagnosis: inpatient Yes · 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 Z38.5 to ICD-9-CMHistory

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

ICD-9-CM
V31.00 Twin-mate lb-hosp w/o cs
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 Z38.5Overview

Is Z38.5 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report twin liveborn infant, unspecified as to place of birth on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Who can Z38.5 be reported for?

The Medicare Code Editor checks twin liveborn infant, unspecified as to place of birth against patient demographics: this code is intended for newborn patients (age 0). Claims outside these limits are flagged as inconsistent.

Is Z38.5 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 twin liveborn infant, unspecified as to place of birth on inpatient claims.

What is the ICD-9 equivalent of Z38.5?

Under the General Equivalence Mappings, twin liveborn infant, unspecified as to place of birth converts to ICD-9-CM V31.00 (twin-mate lb-hosp w/o cs). The mapping is approximate, so confirm the match fits the documentation.