O35 ICD-10-CM Code: Maternal care for known or suspected fetal abnormality and damage
HCC Buddy Code Card
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FY 2026 Apr update / Pregnancy, childbirth and the puerperium (O00-O9A) / Maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)
O35
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceMaternal care for known or suspected fetal abnormality and damage
Maternal care for known or suspected fetal abnormality and damage
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for O35 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for O35 in this effective period.
Related Child Codes
Includes
Official- the listed conditions in the fetus as a reason for hospitalization or other obstetric care to the mother, or for termination of pregnancy
Excludes 1
Official- encounter for suspected maternal and fetal conditions ruled out (Z03.7-)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for O35 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for O35 in this effective period.
Code Also
Official- any associated maternal condition
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Coder workflow notes
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What This Code Means
O35 is the ICD-10-CM diagnosis code for maternal care for known or suspected fetal abnormality and damage. O35 sits in the ICD-10-CM chapter for pregnancy, childbirth and the puerperium (o00-o9a), within the section covering maternal care related to the fetus and amniotic cavity and possible delivery problems (o30-o48).
Header codes like O35 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at O35's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O35 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Includes
- the listed conditions in the fetus as a reason for hospitalization or other obstetric care to the mother, or for termination of pregnancy
Excludes 1, Do NOT code together
- encounter for suspected maternal and fetal conditions ruled out (Z03.7-)
Code Also
- any associated maternal condition