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ICD-10-CM O29.3X2: Toxic reaction to local anesthesia during pregnancy, second trimester

O29.3X2 is the billable ICD-10-CM code for toxic reaction to local anesthesia during pregnancy, second trimester, in category O29 (Complications of anesthesia during pregnancy) of the Other maternal disorders predominantly related to pregnancy section. As a principal diagnosis it groups to MS-DRG 817 Other Antepartum Diagnoses with O.R. Procedures with MCC, MS-DRG 818 Other Antepartum Diagnoses with O.R. Procedures with CC, MS-DRG 819 Other Antepartum Diagnoses with O.R. Procedures without CC/MCC (MDC 14 MDC 14: Pregnancy, Childbirth and the Puerperium). 1 LCD billing and coding article lists it as covered.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
O29.3X2
billable FY2027 ICD-10-CM code
Category
O29 Complications of anesthesia during pregnancy
Chapter
15: Pregnancy, childbirth and the puerperium (O00-O9A)
CC/MCC (MS-DRG v44)
Neither
CMS-HCC V28
Not mapped
POA reporting
Required

Tabular list notes for O29.3X2

The tabular list has no notes on O29.3X2 itself; the notes below apply from its parent headings.

Inherited from O29 (Complications of anesthesia during pregnancy)

Includes
  • maternal complications arising from the administration of a general, regional or local anesthetic, analgesic or other sedation during pregnancy
Excludes2 (not part of this condition, may be coded together)
  • complications of anesthesia during labor and delivery (O74.-)
  • complications of anesthesia during the puerperium (O89.-)
Use additional code
  • code, if necessary, to identify the complication

MS-DRG grouping when O29.3X2 is the principal diagnosis

MS-DRG v44 groups for O29.3X2 as principal diagnosis
MDCMS-DRGs
14 MDC 14: Pregnancy, Childbirth and the Puerperium817818819831832833

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for O29.3X2 shows the full grouping logic.

CC/MCC status and inpatient edits

O29.3X2 is neither a CC nor an MCC under MS-DRG v44, so as a secondary diagnosis it does not raise the MS-DRG severity level. Check O29.3X2 against a principal diagnosis.

  • Present on admission: a POA indicator is required on inpatient claims.
  • Medicare Code Editor: age conflict: maternity diagnosis (age 9 to 64).

CMS-HCC V28 risk adjustment

O29.3X2 does not map to a payment HCC in the PY2027 CMS-HCC V28 model, so on its own it does not change a Medicare Advantage risk score.

LCD billing and coding articles that list O29.3X2

1 current Medicare billing and coding article lists O29.3X2 among the diagnoses that support medical necessity for the services they cover.

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Frequently asked questions

What does ICD-10-CM O29.3X2 mean?

O29.3X2 means toxic reaction to local anesthesia during pregnancy, second trimester. It is one of 25 billable codes under O29, complications of anesthesia during pregnancy.

Which MS-DRG does O29.3X2 group to?

As the principal diagnosis, O29.3X2 groups to MS-DRG 817 Other Antepartum Diagnoses with O.R. Procedures with MCC, MS-DRG 818 Other Antepartum Diagnoses with O.R. Procedures with CC, MS-DRG 819 Other Antepartum Diagnoses with O.R. Procedures without CC/MCC (MDC 14 MDC 14: Pregnancy, Childbirth and the Puerperium) under MS-DRG v44, before procedures and secondary diagnoses are applied.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.