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v1.0.0
ICD-10 Guide
ICD-10 CodesO31.1

O31.1

Billable

Continuing pregnancy after spontaneous abortion of one fetus or more

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

Code Description

ICD-10 O31.1 is a billable code used to indicate a diagnosis of continuing pregnancy after spontaneous abortion of one fetus or more.

Key Diagnostic Point:

O31.1 is used to classify pregnancies that continue after a spontaneous abortion of one or more fetuses. This condition is particularly relevant in cases of multiple gestations, where the loss of one or more fetuses can lead to complex clinical scenarios. The remaining fetus or fetuses may be at risk for various complications, including twin-to-twin transfusion syndrome (TTTS), a condition that occurs in monochorionic twins where blood flow is imbalanced between the fetuses. This imbalance can lead to significant morbidity and mortality if not monitored and managed appropriately. The ongoing pregnancy requires careful surveillance to assess the health of the surviving fetus or fetuses, as well as to monitor for any complications arising from the loss of the other fetus or fetuses. Clinicians must document the details of the spontaneous abortion, the number of fetuses involved, and any complications that arise during the continuation of the pregnancy to ensure accurate coding and optimal patient care.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between spontaneous abortion and elective termination.
  • Identifying complications specific to multiple gestations.
  • Monitoring for twin-to-twin transfusion syndrome and its implications.
  • Documenting the number of fetuses and their respective health statuses.

Audit Risk Factors

  • Inadequate documentation of the spontaneous abortion.
  • Failure to document the number of fetuses and their health status.
  • Lack of follow-up documentation regarding complications.
  • Misclassification of the type of abortion (spontaneous vs. elective).

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of the spontaneous abortion, including gestational age, number of fetuses, and any complications.

Common Clinical Scenarios

Continuing pregnancy after a spontaneous abortion in a twin gestation, monitoring for TTTS.

Billing Considerations

Accurate coding requires thorough documentation of fetal health and any interventions performed.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including maternal health and fetal monitoring.

Common Clinical Scenarios

Management of a pregnancy complicated by TTTS following the loss of a twin.

Billing Considerations

High-risk pregnancies necessitate detailed tracking of both maternal and fetal outcomes.

Coding Guidelines

Inclusion Criteria

Use O31.1 When
  • According to ICD
  • 10 coding guidelines, O31
  • 1 should be used when a pregnancy continues after a spontaneous abortion of one or more fetuses
  • Coders must ensure that all relevant clinical details are documented to support the use of this code

Exclusion Criteria

Do NOT use O31.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59400CPT Code

Obstetrical care including antepartum care, delivery, and postpartum care

Clinical Scenario

Used for comprehensive obstetric care in a patient continuing pregnancy after spontaneous abortion.

Documentation Requirements

Complete documentation of all prenatal visits, delivery, and postpartum follow-up.

Specialty Considerations

Obstetricians must ensure that all aspects of care are 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, including O31.1, which provides better granularity in capturing the complexities of pregnancies following spontaneous abortions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including O31.1, which provides better granularity in capturing the complexities of pregnancies following spontaneous abortions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including O31.1, which provides better granularity in capturing the complexities of pregnancies following spontaneous abortions.

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 documentation is required for coding O31.1?

Documentation must include details of the spontaneous abortion, the number of fetuses, any complications, and follow-up care for the remaining fetus or fetuses.