Coding and coverage · ICD-10-CM

O31 Complications specific to multiple gestation

Not billable (header)Chapter 15

This code needs a 7th character (use X as a placeholder for missing characters).

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Codes under this one

  • O31.0 Papyraceous fetusHeader
  • O31.1 Continuing pregnancy after spontaneous abortion of one fetus or moreHeader
  • O31.2 Continuing pregnancy after intrauterine death of one fetus or moreHeader
  • O31.3 Continuing pregnancy after elective fetal reduction of one fetus or moreHeader
  • O31.4 Continuing pregnancy after vanishing twin syndrome of one fetus or moreHeader
  • O31.8 Other complications specific to multiple gestationHeader

Instructional notes

Chapter 15

Excludes1Not coded here: never report with this code, except when the two conditions are unrelated.
  • supervision of normal pregnancy (Z34.-)
Excludes2Not included here: the patient may have both; report both when both are present.
  • mental and behavioral disorders associated with the puerperium (F53.-)
  • obstetrical tetanus (A34)
  • postpartum necrosis of pituitary gland (E23.0)
  • puerperal osteomalacia (M83.0)
Use additional codeAdd a second code for the full picture.
  • code, if applicable, from category Z3A, Weeks of gestation, to identify the specific week of the pregnancy, if known.
Notes
  • 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

This code

Excludes2Not included here: the patient may have both; report both when both are present.
  • delayed delivery of second twin, triplet, etc. (O63.2)
  • malpresentation of one fetus or more (O32.9)
  • placental transfusion syndromes (O43.0-)
7th charactersOne of the following 7th characters is to be assigned to each code under category O31. 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 O31 that has a 7th character of 1 through 9.
  • 0 not applicable or unspecified
  • 1 fetus 1
  • 2 fetus 2
  • 3 fetus 3
  • 4 fetus 4
  • 5 fetus 5
  • 9 other fetus

Chapter 15: Pregnancy, childbirth and the puerperium (O00-O9A) · O30-O48 Maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)

Source: ICD-10-CM FY 2027 code descriptions and tabular list (CMS and CDC National Center for Health Statistics), effective 2026-10-01 through 2027-09-30 · CMS ICD-10 files. HCC mapping: CMS-HCC V28, payment year 2027. As of 2026-11-04.

Coverage and payment depend on the claim details; confirm with the Medicare Administrative Contractor.