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ICD-10 Guide
ICD-10 CodesO03.2

O03.2

Billable

Embolism following incomplete spontaneous abortion

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/08/2025

Code Description

ICD-10 O03.2 is a billable code used to indicate a diagnosis of embolism following incomplete spontaneous abortion.

Key Diagnostic Point:

Embolism following incomplete spontaneous abortion refers to a serious complication that can occur when a miscarriage does not fully expel all products of conception. This condition can lead to the formation of blood clots that may travel to the lungs (pulmonary embolism) or other parts of the body, posing significant health risks to the patient. Incomplete spontaneous abortion, commonly known as miscarriage, can occur at various stages of pregnancy, typically within the first trimester. Factors such as cervical incompetence, maternal age, and underlying health conditions can contribute to the risk of miscarriage. Emotional support is crucial for patients experiencing this condition, as it can be a traumatic event. Healthcare providers should offer counseling and resources to help patients cope with the emotional aftermath of a miscarriage, alongside addressing the physical complications that may arise, such as embolism. Proper management and follow-up care are essential to ensure the patient's recovery and to prevent further complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between complete and incomplete abortion
  • Identifying the presence of embolism and its implications
  • Understanding the stages of miscarriage and associated risks
  • Documenting emotional support and counseling provided

Audit Risk Factors

  • Inadequate documentation of the miscarriage type
  • Failure to document emotional support provided
  • Misclassification of the type of embolism
  • Lack of follow-up care documentation

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include details of the miscarriage, any interventions performed, and emotional support provided.

Common Clinical Scenarios

Patients presenting with bleeding and cramping in early pregnancy, requiring evaluation for incomplete abortion.

Billing Considerations

Ensure accurate coding of the type of abortion and any complications, including emotional support measures.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancy documentation must include maternal health history, risk factors for miscarriage, and management plans.

Common Clinical Scenarios

Management of patients with recurrent pregnancy loss or those with known cervical incompetence.

Billing Considerations

Consider the implications of maternal health on pregnancy outcomes and the need for specialized care.

Coding Guidelines

Inclusion Criteria

Use O03.2 When
  • Follow official coding guidelines that emphasize the importance of documenting the type of abortion, any complications, and the emotional support provided to the patient

Exclusion Criteria

Do NOT use O03.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59400CPT Code

Obstetric care including antepartum care, delivery, and postpartum care

Clinical Scenario

Used in conjunction with O03.2 when managing a patient with incomplete abortion and subsequent complications.

Documentation Requirements

Documentation must include details of the abortion, complications, and follow-up care.

Specialty Considerations

Obstetricians should ensure comprehensive care is documented to support billing.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the accuracy of diagnoses and the ability to track complications such as embolism following incomplete spontaneous abortion.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the accuracy of diagnoses and the ability to track complications such as embolism following incomplete spontaneous abortion.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the accuracy of diagnoses and the ability to track complications such as embolism following incomplete spontaneous abortion.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What should be documented for O03.2?

Documentation should include the type of abortion, any complications such as embolism, emotional support provided, and follow-up care plans.