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v1.0.0
ICD-10 Guide
ICD-10 CodesO03.89

O03.89

Billable

Complete or unspecified spontaneous abortion with other complications

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

Code Description

ICD-10 O03.89 is a billable code used to indicate a diagnosis of complete or unspecified spontaneous abortion with other complications.

Key Diagnostic Point:

O03.89 refers to a complete or unspecified spontaneous abortion that occurs with additional complications. Spontaneous abortion, commonly known as miscarriage, is defined as the loss of a pregnancy before the 20th week of gestation. This condition can occur due to various factors, including chromosomal abnormalities, maternal health issues, or environmental factors. Complications may include retained products of conception, infection, or excessive bleeding. The emotional impact on the patient can be significant, necessitating psychological support and counseling. It is essential for healthcare providers to document the specifics of the abortion, including gestational age, any complications encountered, and the emotional support provided to the patient. Accurate coding is crucial for appropriate management and follow-up care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between complete and incomplete spontaneous abortion.
  • Identifying and documenting associated complications.
  • Understanding the gestational age at the time of abortion.
  • Assessing the need for follow-up care and emotional support.

Audit Risk Factors

  • Inadequate documentation of complications.
  • Failure to specify the type of spontaneous abortion.
  • Lack of follow-up notes regarding emotional support.
  • Misclassification of gestational age.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of the patient's history, physical examination findings, and any complications encountered during the spontaneous abortion.

Common Clinical Scenarios

Patients presenting with vaginal bleeding, cramping, or loss of pregnancy symptoms.

Billing Considerations

Consideration of the patient's emotional state and the provision of psychological support.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of maternal and fetal health, especially in high-risk pregnancies.

Common Clinical Scenarios

Management of patients with recurrent pregnancy loss or those with underlying health conditions.

Billing Considerations

Focus on the implications of complications on future pregnancies.

Coding Guidelines

Inclusion Criteria

Use O03.89 When
  • According to the official ICD
  • 10 coding guidelines, O03
  • 89 should be used when a spontaneous abortion occurs with other complications
  • Coders must ensure that all relevant details are documented to support the use of this code

Exclusion Criteria

Do NOT use O03.89 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59400CPT Code

Obstetric care, antepartum, 4-6 visits

Clinical Scenario

Used for routine care of patients with a history of spontaneous abortion.

Documentation Requirements

Document all visits and any complications encountered.

Specialty Considerations

Obstetricians should ensure comprehensive care plans are in place.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of spontaneous abortion and its complications, improving the accuracy of patient records and facilitating better care management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of spontaneous abortion and its complications, improving the accuracy of patient records and facilitating better care management.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What is the difference between complete and incomplete spontaneous abortion?

Complete spontaneous abortion refers to the complete expulsion of all products of conception, while incomplete spontaneous abortion indicates that some products remain in the uterus, which may require further medical intervention.