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v1.0.0
ICD-10 Guide
ICD-10 CodesO07.4

O07.4

Billable

Failed attempted termination of pregnancy without complication

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

Code Description

ICD-10 O07.4 is a billable code used to indicate a diagnosis of failed attempted termination of pregnancy without complication.

Key Diagnostic Point:

Failed attempted termination of pregnancy without complication (O07.4) refers to instances where a medical or surgical procedure intended to terminate a pregnancy has not succeeded, resulting in the continuation of the pregnancy without any immediate complications. This code is applicable when the patient has undergone an attempted termination, such as a medical abortion or dilation and curettage (D&C), but the procedure did not achieve the desired outcome. Clinically, this may manifest as retained products of conception or an ongoing pregnancy despite the attempt to terminate. It is crucial for healthcare providers to monitor the patient closely following a failed termination attempt to ensure that no complications arise, such as infection or hemorrhage. Management may involve further medical intervention, counseling regarding options, and follow-up care to assess the status of the pregnancy. Documentation should clearly outline the procedure attempted, the outcome, and any subsequent management provided to ensure accurate coding and billing.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between failed termination and other obstetric complications.
  • Understanding the nuances of documentation for attempted procedures.
  • Identifying the need for follow-up care and its implications for coding.
  • Navigating the emotional and psychological aspects of care that may affect documentation.

Audit Risk Factors

  • Inadequate documentation of the attempted procedure.
  • Failure to document follow-up care or complications.
  • Misclassification of the outcome of the termination attempt.
  • Lack of clarity in patient consent and counseling documentation.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include details of the attempted termination, patient consent, and any follow-up care provided.

Common Clinical Scenarios

Patients presenting for medical abortion, surgical abortion, or those experiencing complications post-termination attempt.

Billing Considerations

Consideration of the patient's emotional state and counseling needs is essential for accurate coding.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancy documentation must include detailed assessments of maternal and fetal health post-failed termination.

Common Clinical Scenarios

Complex cases involving high-risk factors that may complicate the management of a failed termination.

Billing Considerations

Special attention to the potential for maternal-fetal complications and the need for multidisciplinary care.

Coding Guidelines

Inclusion Criteria

Use O07.4 When
  • According to official coding guidelines, O07
  • 4 should be used when a termination attempt fails without complications
  • Coders must ensure that documentation supports the diagnosis and that all relevant procedures are accurately captured

Exclusion Criteria

Do NOT use O07.4 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59840CPT Code

Medical abortion, medication management

Clinical Scenario

Used when a medical abortion is attempted but fails.

Documentation Requirements

Documentation of the medication used, dosage, and follow-up care.

Specialty Considerations

Obstetricians should ensure that counseling and consent are documented.

58120CPT Code

Dilation and curettage (D&C)

Clinical Scenario

Used when a surgical abortion is attempted but fails.

Documentation Requirements

Detailed operative notes and post-operative assessments are required.

Specialty Considerations

Ensure that any complications are documented to avoid misclassification.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of failed termination attempts, improving the granularity of data collection and enhancing the ability to track outcomes and complications.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of failed termination attempts, improving the granularity of data collection and enhancing the ability to track outcomes and complications.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of failed termination attempts, improving the granularity of data collection and enhancing the ability to track outcomes and complications.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What should be documented for a failed termination attempt?

Documentation should include the type of procedure attempted, patient consent, any complications or lack thereof, and follow-up care provided. Clear notes on the patient's emotional state and counseling offered are also important.