ICD-10 O28.9
Billable / SpecificUnspecified abnormal findings on antenatal screening of mother
About ICD-10-CM O28.9
ICD-10-CM code O28.9 represents Unspecified abnormal findings on antenatal screening of mother. This is a billable/specific code in the Pregnancy, Childbirth, and Puerperium chapter (block O28). The 2026 edition of ICD-10-CM O28.9 became effective on October 1, 2025.
Coding Tips for O28.9
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.
Medicare LCD Coverage for O28.9
Local Coverage Determinations (LCDs) from CMS MACs that list O28.9 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 O28.9.
2 Aetna
1 Cigna
CPT Codes Commonly Billed with O28.9
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
Convert O28.9 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| O28.9 | 7965 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To O28.9
Other codes in section O20-O29 (Other maternal disorders predominantly related to pregnancy).
ICD-10 O28.9, Billing FAQ
Is ICD-10 code O28.9 billable? +
Yes, O28.9 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What CPT codes are commonly billed with O28.9? +
Procedures frequently paired with O28.9 include: 76801, 76805.
What ICD-9 codes does O28.9 map to? +
Per CMS GEMs, O28.9 maps to ICD-9 codes: 7965. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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