O60.23X4Term delivery with preterm labor, third trimester, fetus 4

O60.23X4 is the ICD-10-CM diagnosis code for term delivery with preterm labor, third trimester, fetus 4. It belongs to category O60 (preterm labor), 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.

The 7th character "4" means fetus 4.

As a secondary diagnosis it is an MCC (major complication or comorbidity), which can move an inpatient stay into the highest-paying "with MCC" 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 644.21 (early onset of delivery, delivered, with or without mention of antepartum condition).