O85-O92
Medium Complexity
Complications predominantly related to the puerperium
Primary Specialty: Obstetrics and Gynecology
Last Updated: 2025-09-09
ICD-10 Codes (149)
113 billable29 category headers
O86O86.0O86.00Billable
O86.01Billable
O86.02Billable
O86.03Billable
O86.04Billable
O86.09Billable
O86.1O86.11Billable
O86.12Billable
O86.13Billable
O86.19Billable
O86.2O86.20Billable
O86.21Billable
O86.22Billable
O86.29Billable
O86.4Billable
O86.8O86.81Billable
O86.89Billable
O87O87.0Billable
O87.1Billable
O87.2Billable
O87.3Billable
O87.4Billable
O87.8Billable
O87.9Billable
O88O88.0O88.01O88.011Billable
O88.012Billable
O88.013Billable
O88.019Billable
O88.02Billable
O88.03Billable
O88.1O88.11O88.111Billable
O88.112Billable
O88.113Billable
O88.119Billable
O88.12Billable
O88.13Billable
O88.2O88.21O88.211Billable
O88.212Billable
O88.213Billable
O88.219Billable
O88.22Billable
O88.23Billable
O88.3O88.31O88.311Billable
O88.312Billable
O88.313Billable
O88.319Billable
O88.32Billable
O88.33Billable
O88.8O88.81O88.811Billable
O88.812Billable
O88.813Billable
O88.819Billable
O88.82Billable
O88.83Billable
O89O89.0O89.01Billable
O89.09Billable
O89.1Billable
O89.2Billable
O89.3Billable
O89.4Billable
O89.5Billable
O89.6Billable
O89.8Billable
O89.9Billable
O90O90.0Billable
O90.1Billable
O90.2Billable
O90.3Billable
O90.4O90.41Billable
O90.49Billable
O90.5Billable
O90.6Billable
O90.8O90.81Billable
O90.89Billable
O90.9Billable
O91O91.0O91.01O91.011Billable
O91.012Billable
O91.013Billable
O91.019Billable
O91.02Billable
O91.03Billable
O91.1O91.11O91.111Billable
O91.112Billable
O91.113Billable
O91.119Billable
O91.12Billable
O91.13Billable
O91.2O91.21O91.211Billable
O91.212Billable
O91.213Billable
O91.219Billable
O91.22Billable
O91.23Billable
O92O92.0O92.01O92.011Billable
O92.012Billable
O92.013Billable
O92.019Billable
O92.02Billable
O92.03Billable
O92.1O92.11O92.111Billable
O92.112Billable
O92.113Billable
O92.119Billable
O92.12Billable
O92.13Billable
O92.2O92.20Billable
O92.29Billable
O92.3Billable
O92.4Billable
O92.5Billable
O92.6Billable
O92.7O92.70Billable
O92.79Billable
Updates & Changes
FY 2026 Updates
Current Year
New Codes (1)
O03.87
Complete or unspecified spontaneous abortion with embolism, complicated by delayed or excessive hemorrhage
Revised Codes (1)
O00.9
Ectopic pregnancy, unspecified - updated hCG correlation requirements
Deleted Codes
No codes deleted in this range for FY 2026
Historical Changes
- •FY 2025: Routine maintenance updates with minor terminology clarifications
- •FY 2024: Enhanced specificity requirements for certain code ranges
- •FY 2023: Updated documentation guidelines for improved clarity
Upcoming Changes
- •Proposed updates pending review by Coordination and Maintenance Committee
- •Under consideration: Enhanced digital health integration codes
Implementation Guidance
- •Review all FY 2026 updates for O85-O92 codes before implementation
- •Always verify the most current codes in the ICD-10-CM manual
- •Ensure clinical documentation supports the selected diagnosis codes
- +3 more guidance items...
Range Overview
high priority
The ICD-10 category O85-O92 encompasses codes that represent complications predominantly related to the puerperium. The puerperium is the period following childbirth during which the mother's reproductive organs return to their normal nonpregnant state. This category includes conditions such as puerperal sepsis, obstetric embolism, and complications of the breasts and lactation. These codes are used to document complications that occur during the postpartum period, typically within six weeks after delivery.
Key Usage Points:
- •These codes are used specifically for complications occurring during the puerperium, not during pregnancy or delivery.
- •The codes can be used in conjunction with other codes to provide a more complete picture of the patient's condition.
- •The codes should not be used for conditions that existed prior to the puerperium, unless they became complicated during this period.
- •The codes in this category are not gender-specific and can be used for any individual who has given birth.
- •The use of these codes requires detailed documentation of the patient's condition and the complications experienced.
Coding Guidelines
When to Use:
- ✓When a patient experiences a postpartum infection, such as puerperal sepsis.
- ✓When a patient suffers from an obstetric embolism during the puerperium.
- ✓When a patient has complications related to lactation, such as mastitis.
- ✓When a patient has a postpartum hemorrhage or other complications of the genital tract.
When NOT to Use:
- ✗When the patient's condition existed prior to the puerperium and did not become complicated during this period.
- ✗When the patient's condition is not directly related to the puerperium.
- ✗When the patient did not recently give birth.
- ✗When the patient's condition is better represented by another code.
Code Exclusions
Always verify the exclusions with the patient's medical record and the ICD-10 guidelines.
Documentation Requirements
Documentation for codes in the O85-O92 range should include a detailed description of the patient's condition, the complications experienced, and the relationship of these complications to the puerperium. The documentation should also include the patient's medical history and any treatments provided.
Clinical Information:
- •Detailed description of the patient's condition
- •Specific complications experienced by the patient
- •Relationship of the complications to the puerperium
- •Patient's medical history
- •Treatments provided to the patient
Supporting Evidence:
- •Laboratory test results
- •Imaging studies
- •Notes from the patient's healthcare providers
- •Records of treatments provided
Good Documentation Example:
Patient presented with fever, abdominal pain, and foul-smelling lochia 4 days postpartum. Diagnosed with puerperal sepsis. Started on IV antibiotics.
Poor Documentation Example:
Patient has fever postpartum.
Common Documentation Errors:
- âš Not providing enough detail about the patient's condition
- âš Not clearly linking the complications to the puerperium
- âš Not including supporting evidence
- âš Not documenting treatments provided
Range Statistics
Total Codes
113
Billable
Complexity:
Medium
Primary Use:Clinical Documentation
Chapter:15
Coding Complexity
Medium
Complexity Rating
The complexity of coding in the O85-O92 range is considered medium because it requires a thorough understanding of the conditions represented by each code and the relationship of these conditions to the puerperium. It also requires the ability to identify any pre-existing conditions and use additional codes as necessary.
Key Factors:
- â–¸Understanding the specific conditions represented by each code
- â–¸Determining the relationship of the condition to the puerperium
- â–¸Identifying any pre-existing conditions
- â–¸Using additional codes to provide a more complete picture of the patient's condition
Specialty Focus
These codes are most commonly used by obstetricians, gynecologists, and midwives. They may also be used by family practitioners and other healthcare providers who care for patients during the postpartum period.
Primary Specialties:
Obstetrics and Gynecology
70%
Family Practice
20%
Clinical Scenarios:
- • A patient presents with a high fever and abdominal pain a few days after giving birth and is diagnosed with puerperal sepsis.
- • A patient experiences a pulmonary embolism during the puerperium.
- • A patient develops mastitis while breastfeeding.
- • A patient has a postpartum hemorrhage.
Resources & References
There are many resources available to help with coding in the O85-O92 range, including the official ICD-10 guidelines, clinical reference sources, and educational materials.
Official Guidelines:
- ICD-10-CM Official Guidelines for Coding and Reporting
- World Health Organization's ICD-10 guidelines
- National Center for Health Statistics ICD-10 resources
Clinical References:
- American College of Obstetricians and Gynecologists guidelines
- World Health Organization's guidelines on maternal health
Educational Materials:
- American Health Information Management Association's coding resources
- American Academy of Professional Coders' ICD-10 resources
Frequently Asked Questions
Can these codes be used for complications that occur during pregnancy or delivery?
No, these codes are specifically for complications that occur during the puerperium, which is the period following childbirth.
Can these codes be used for patients who have not given birth?
No, these codes are specifically for individuals who have given birth and are experiencing complications during the puerperium.