ICD-10 O98.81
Non-Billable HeaderOther maternal infectious and parasitic diseases complicating pregnancy
About ICD-10-CM O98.81
ICD-10-CM code O98.81 represents Other maternal infectious and parasitic diseases complicating pregnancy. This is a non-billable header code in the Pregnancy, Childbirth, and Puerperium chapter (block O98). The 2026 edition of ICD-10-CM O98.81 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 O98.81
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 O98.81
Local Coverage Determinations (LCDs) from CMS MACs that list O98.81 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 O98.81.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but O98.81 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with O98.81
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 O98.81
Other codes in section O94-O9A (Other obstetric conditions, not elsewhere classified).
ICD-10 O98.81, Billing FAQ
Is ICD-10 code O98.81 billable? +
No, O98.81 is a non-billable header code. Use a more specific child code from block O98 when submitting claims.
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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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