O68Billable, valid for claims from October 1, 2026

Labor and delivery complicated by abnormality of fetal acid-base balance

In Complications of labor and delivery (O60-O77), chapter 15: Pregnancy, Childbirth and the Puerperium

  • O68 is billable and valid on claims for FY 2027. If the record has more detail, check the other codes under O60-O77 below.
  • As a secondary diagnosis it is a CC (complication or comorbidity), which can raise the MS-DRG payment. It doesn't count when the principal diagnosis is one of 3 closely related codes.
  • Doesn't count toward a Medicare Advantage risk score (no HCC in V28).
  • AHRQ's Chronic Condition Indicator classes it as not chronic (an acute or short-term condition).
  • Expected only on maternity records. (Maternity list)

Also indexed as: Delivery, complicated, by, fetal, abnormal acid-base balance; Delivery, complicated, by, fetal, acidemia; Delivery, complicated, by, fetal, acidosis; Delivery, complicated, by, fetal, alkalosis; Pregnancy, complicated by, fetal, abnormality or damage, acid-base balance; Pregnancy, complicated by, fetal, acidemia; Pregnancy, complicated by, fetal, acidosis; Pregnancy, complicated by, fetal, alkalosis

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Instructional notes

Includes: conditions that are coded here

  • Fetal acidemia complicating labor and delivery
  • Fetal acidosis complicating labor and delivery
  • Fetal alkalosis complicating labor and delivery
  • Fetal metabolic acidemia complicating labor and delivery

Excludes1: not coded here, use a different code

  • fetal stress NOS (O77.9)
  • labor and delivery complicated by electrocardiographic evidence of fetal stress (O77.8)
  • labor and delivery complicated by ultrasonic evidence of fetal stress (O77.8)

Excludes2: not included here, code separately if applicable

  • abnormality in fetal heart rate or rhythm (O76)
  • labor and delivery complicated by meconium in amniotic fluid (O77.0)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Coding of obstetric cases with O00-O9A codes: sequencing priority, trimester and fetus characters, principal diagnosis selection, delivery outcome, and pregnancy-related complications.

Read Section I.C.15 (page 63), 11 more topics

O68 MS-DRGs

This code does not group to an MS-DRG as a principal diagnosis.

Related conditions

Grouped by AHRQ's Clinical Classifications Software Refined (CCSR), which sorts every diagnosis code into clinically meaningful categories.

O68 is in Malposition, disproportion or other labor complications (PRG024, its default category), with 259 codes. Others in it:

  • O32.0XX0 Maternal care for unstable lie, not applicable or unspecified
  • O32.0XX1 Maternal care for unstable lie, fetus 1
  • O32.0XX2 Maternal care for unstable lie, fetus 2
  • O32.0XX3 Maternal care for unstable lie, fetus 3
  • O32.0XX4 Maternal care for unstable lie, fetus 4
  • O32.0XX5 Maternal care for unstable lie, fetus 5
  • O32.0XX9 Maternal care for unstable lie, other fetus
  • O32.1XX0 Maternal care for breech presentation, not applicable or unspecified

Other codes that refer to O68

Notes on these codes point to O68.

  • O76 Excludes2: fetal metabolic acidemia (O68)
  • O77.8 Excludes1: abnormality of fetal acid-base balance (O68)
  • O77.8 Excludes1: fetal metabolic acidemia (O68)
  • O77.9 Excludes1: abnormality of fetal acid-base balance (O68)
  • O77.9 Excludes1: fetal metabolic acidemia (O68)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Childbirth Problems

Childbirth is the process of giving birth to a baby. It includes labor and delivery. Usually everything goes well, but problems can happen. They may cause a risk to the mother, baby, or both. Some of the more common childbirth problems include:

Read more about childbirth problems on MedlinePlus

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.

ICD-9-CM equivalent

Legacy crosswalk from the CMS General Equivalence Mappings (last updated 2018).

  • 656.31 Fetal distress, affecting management of mother, delivered, with or without mention of antepartum condition (approximate)
  • 656.81 Other specified fetal and placental problems, affecting management of mother, delivered, with or without mention of antepartum condition (approximate)
ICD-9 to ICD-10 converter