ICD-10 O31
Non-Billable HeaderComplications specific to multiple gestation
About ICD-10-CM O31
ICD-10-CM code O31 represents Complications specific to multiple gestation. This is a non-billable header code in the Pregnancy, Childbirth, and Puerperium chapter (block O31). The 2026 edition of ICD-10-CM O31 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 O31
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 2 Excludes
Not included here, the excluded code is not part of O31, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- delayed delivery of second twin, triplet, etc. (O63.2)
- malpresentation of one fetus or more (O32.9)
- placental transfusion syndromes (O43.0-)
Coding Notes
Seven Chr Note
- One 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.
Medicare LCD Coverage for O31
Local Coverage Determinations (LCDs) from CMS MACs that list O31 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 O31.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but O31 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with O31
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 O31
Other codes in section O30-O48 (Maternal care related to the fetus and amniotic cavity and possible delivery problems).
ICD-10 O31, Billing FAQ
Is ICD-10 code O31 billable? +
No, O31 is a non-billable header code. Use a more specific child code from block O31 when submitting claims.
What codes are Type 2 Excludes for O31? +
Type 2 Excludes (may be coded together when both conditions exist): delayed delivery of second twin, triplet, etc. (O63.2); malpresentation of one fetus or more (O32.9); placental transfusion syndromes (O43.0-)
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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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