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    v1.0.28
    OpenPayerBilling CodesMaternal care related to the fetus and amniotic cavity and possible delivery problemsICD-10-CM o31-complications-specific-to-multiple-gestation
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    ICD-10-CM Code For Complications Specific To Multiple Gestation: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group O31 includes diagnoses for complications unique to multiple gestation pregnancies, such as twin-to-twin transfusion, concordance or discordance of fetal conditions, and complications related to shared placental or amniotic structures. These ICD-10-CM diagnosis codes are used to document maternal and fetal clinical scenarios that capture gestational complexity, inter-fetal complications, and involvement of the amniotic cavity or placenta. Accurate coding within the ICD-10-CM O31 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

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    ICD-10-CM O31: Complications Specific To Multiple Gestation Overview

    This group includes diagnoses that describe complications unique to pregnancies with more than one fetus, such as twin or higher-order gestations. It targets maternal-fetal conditions affecting the amniotic cavity, placenta, and inter-fetal relationships. Accurate coding supports correct clinical documentation and influences reimbursement through precise capture of pregnancy complexity.

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    When to Use

    Use a code from this group when the pregnancy involves two or more fetuses and a complication arises that is specific to multiple gestation, such as unequal fetal growth attributable to shared placental circulation. Codes are selected when clinical documentation specifies a complication related to the placenta, amniotic cavity, or inter-fetal interactions in a multiple pregnancy.

    ICD-10-CM Codes

    140 rows

    ICD-10-CM CodeDescription
    O31.00X0Papyraceous fetus, unspecified trimester, not applicable or unspecified
    O31.00X1Papyraceous fetus, unspecified trimester, fetus 1
    O31.00X2Papyraceous fetus, unspecified trimester, fetus 2
    O31.00X3Papyraceous fetus, unspecified trimester, fetus 3
    O31.00X4Papyraceous fetus, unspecified trimester, fetus 4
    O31.00X5Papyraceous fetus, unspecified trimester, fetus 5
    O31.00X9Papyraceous fetus, unspecified trimester, other fetus
    O31.01X0Papyraceous fetus, first trimester, not applicable or unspecified
    O31.01X1Papyraceous fetus, first trimester, fetus 1
    O31.01X2Papyraceous fetus, first trimester, fetus 2
    O31.01X3Papyraceous fetus, first trimester, fetus 3
    O31.01X4Papyraceous fetus, first trimester, fetus 4
    O31.01X5Papyraceous fetus, first trimester, fetus 5
    O31.01X9Papyraceous fetus, first trimester, other fetus
    O31.02X0Papyraceous fetus, second trimester, not applicable or unspecified
    O31.02X1Papyraceous fetus, second trimester, fetus 1
    O31.02X2Papyraceous fetus, second trimester, fetus 2
    O31.02X3Papyraceous fetus, second trimester, fetus 3
    O31.02X4Papyraceous fetus, second trimester, fetus 4
    O31.02X5Papyraceous fetus, second trimester, fetus 5

    Showing 1–20 of 140

    DRG Codes

    6 rows

    DRG CodeDescription
    817Other Antepartum Diagnoses with O.R. Procedures with MCC
    818Other Antepartum Diagnoses with O.R. Procedures with CC
    819Other Antepartum Diagnoses with O.R. Procedures without CC/MCC
    831Other Antepartum Diagnoses without O.R. Procedures with MCC
    832Other Antepartum Diagnoses without O.R. Procedures with CC
    833Other Antepartum Diagnoses without O.R. Procedures without CC/MCC

    Typical Clinical Scenarios

    • A pregnant woman at 28 weeks gestation presents to triage with sudden onset of severe abdominal pain and decreased fetal movements; ultrasound reveals discordant growth in twins with one twin showing signs of intrauterine demise. She is admitted for monitoring and management of a complicated multiple pregnancy with fetal death of one fetus, which warrants assignment of a code indicating multiple gestation with intrauterine death. Typical codes: O31.11X0, O31.11X1
    • A patient with a known dichorionic-diamniotic twin pregnancy is seen in a routine prenatal visit for progressive polyhydramnios affecting the first twin, causing maternal dyspnea and discomfort; amniotic fluid index is markedly elevated and interventions are planned to address amniotic fluid imbalance. Because this is a complication specific to one fetus within a multiple gestation involving excessive amniotic fluid, a code from this group for polyhydramnios in a multiple pregnancy is assigned. Typical codes: O31.20X0, O31.20X1
    • A woman in active labor with triplets presents with malpresentation of one fetus identified on intrapartum ultrasound and concern for delivery complications requiring operative delivery planning. The intrapartum malpresentation in the context of a multiple gestation necessitates coding for malpresentation specific to multiple pregnancy to capture the delivery risk and care needs. Typical codes: O31.30X0, O31.30X1

    Related Codes

    O30-MULTIPLE-GESTATION-PREGNANCY

    ICD-10-CM Code For Multiple Gestation: Group Overview

    O32-MALPRESENTATION-OF-FETUS

    ICD-10-CM Code For Maternal Care For Malpresentation Of Fetus: Group Overview

    O33-MATERNAL-CARE-FOR-DISPROPORTION

    ICD-10-CM Code For Maternal Care For Disproportion: Group Overview

    O34-ABNORMALITY-OF-PELVIC-ORGANS

    ICD-10-CM Code For Maternal Care For Abnormality Of Pelvic Organs: Group Overview

    O35-MATERNAL-CARE-FOR-FETAL-ABNORMALITY

    ICD-10-CM Code For Maternal Care For Known Or Suspected Fetal Abnormality And Damage: Group Overview

    O36-MATERNAL-CARE-OTHER-FETAL-PROBLEMS

    ICD-10-CM Code For Maternal Care For Other Fetal Problems: Group Overview

    O40-POLYHYDRAMNIOS

    ICD-10-CM Code For Polyhydramnios: Group Overview

    O41-OTHER-DISORDERS-OF-AMNIOTIC-FLUID

    ICD-10-CM Code For Other Disorders Of Amniotic Fluid And Membranes: Group Overview

    O42-PREMATURE-RUPTURE-OF-MEMBRANES

    ICD-10-CM Code For Premature Rupture Of Membranes: Group Overview

    O43-PLACENTAL-DISORDERS

    ICD-10-CM Code For Placental Disorders: Group Overview

    Showing 1–10 of 15

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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