ICD-10 O28
Non-Billable HeaderAbnormal findings on antenatal screening of mother
About ICD-10-CM O28
ICD-10-CM code O28 represents Abnormal findings on antenatal screening of mother. This is a non-billable header code in the Pregnancy, Childbirth, and Puerperium chapter (block O28). The 2026 edition of ICD-10-CM O28 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Coding Tips for O28
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
Most O codes require a 7th character indicating trimester (1 = first, 2 = second, 3 = third). Some require fetus identification character. Code O09 (supervision of high-risk pregnancy) is required as a secondary code when applicable.
Type 1 Excludes
Pure excludes, these codes can never be coded together with O28. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- diagnostic findings classified elsewhere - see Alphabetical Index
Medicare LCD Coverage for O28
Local Coverage Determinations (LCDs) from CMS MACs that list O28 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing O28.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but O28 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with O28
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To O28
Other codes in section O20-O29 (Other maternal disorders predominantly related to pregnancy).
ICD-10 O28, Billing FAQ
Is ICD-10 code O28 billable? +
No, O28 is a non-billable header code. Use a more specific child code from block O28 when submitting claims.
What codes are Type 1 Excludes for O28? +
Type 1 Excludes (never code together with O28): diagnostic findings classified elsewhere - see Alphabetical Index
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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