O68Labor and delivery complicated by abnormality of fetal acid-base balance

O68 is the ICD-10-CM diagnosis code for labor and delivery complicated by abnormality of fetal acid-base balance. It belongs to block O60-O77 (complications of labor and delivery) and chapter 15 (pregnancy, childbirth and the puerperium). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Don't report O68 together with the conditions in its Excludes1 note: fetal stress NOS (O77.9), labor and delivery complicated by electrocardiographic evidence of fetal stress (O77.8) and labor and delivery complicated by ultrasonic evidence of fetal stress (O77.8).

The conditions in its Excludes2 note aren't part of O68, but may be coded alongside it if the patient has both: abnormality in fetal heart rate or rhythm (O76) and labor and delivery complicated by meconium in amniotic fluid (O77.0).

As a secondary diagnosis it is a CC (complication or comorbidity), which can move an inpatient stay into the "with CC" MS-DRG of its family, unless the principal diagnosis excludes it.

In MS-DRG v44.0, it is part of the grouping logic for DRG 998 (Principal Diagnosis Invalid as Discharge Diagnosis), in MDC 14 (Pregnancy, Childbirth and the Puerperium), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

The Medicare Code Editor treats this as a maternity diagnosis, expected only for patients age 9 through 64.

It is on the CMS list of diagnoses consistent only with female patients (the sex-conflict edit itself was retired in FY2025).

It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.

Before ICD-10, this condition was coded in ICD-9-CM as 656.31 (fetal distress, affecting management of mother, delivered, with or without mention of antepartum condition) and 656.81 (other specified fetal and placental problems, affecting management of mother, delivered, with or without mention of antepartum condition).