ICD-10 O98
Non-Billable HeaderMaternal infectious and parasitic diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium
About ICD-10-CM O98
ICD-10-CM code O98 represents Maternal infectious and parasitic diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium. This is a non-billable header code in the Pregnancy, Childbirth, and Puerperium chapter (block O98). The 2026 edition of ICD-10-CM O98 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 O98
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 O98, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- herpes gestationis (O26.4-)
- infectious carrier state (O99.82-, O99.83-)
- obstetrical tetanus (A34)
- puerperal infection (O86.-)
- puerperal sepsis (O85)
- when the reason for maternal care is that the disease is known or suspected to have affected the fetus (O35-O36)
Includes
- the listed conditions when complicating the pregnant state, when aggravated by the pregnancy, or as a reason for obstetric care
Use Additional Code
When coding O98, also report these additional codes when applicable.
- code (Chapter 1), to identify specific infectious or parasitic disease
Medicare LCD Coverage for O98
Local Coverage Determinations (LCDs) from CMS MACs that list O98 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 O98.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but O98 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with O98
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 O98
Other codes in section O94-O9A (Other obstetric conditions, not elsewhere classified).
ICD-10 O98, Billing FAQ
Is ICD-10 code O98 billable? +
No, O98 is a non-billable header code. Use a more specific child code from block O98 when submitting claims.
What codes are Type 2 Excludes for O98? +
Type 2 Excludes (may be coded together when both conditions exist): herpes gestationis (O26.4-); infectious carrier state (O99.82-, O99.83-); obstetrical tetanus (A34)
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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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