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ICD-10 Guide
ICD-10 CodesO03.7

O03.7

Billable

Embolism following complete or unspecified spontaneous abortion

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

Code Description

ICD-10 O03.7 is a billable code used to indicate a diagnosis of embolism following complete or unspecified spontaneous abortion.

Key Diagnostic Point:

Embolism following complete or unspecified spontaneous abortion refers to a serious complication that can occur after a miscarriage, where a blood clot travels through the bloodstream and lodges in a blood vessel, potentially leading to life-threatening conditions such as pulmonary embolism or deep vein thrombosis. Spontaneous abortion, commonly known as miscarriage, is defined as the loss of a pregnancy before the 20th week. It can occur at various stages, with early miscarriages often linked to chromosomal abnormalities, while later losses may involve maternal health issues or cervical incompetence. Cervical incompetence, characterized by the premature opening of the cervix, can lead to second-trimester losses and may require surgical intervention or cervical cerclage in future pregnancies. Emotional support is crucial for patients experiencing spontaneous abortion, as it can lead to significant psychological distress. Healthcare providers should offer counseling and resources to help patients cope with their loss and navigate subsequent pregnancies safely.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between complete and incomplete spontaneous abortion
  • Identifying the presence of embolism and its clinical implications
  • Understanding the timing of the abortion and its impact on coding
  • Documenting emotional and psychological support provided to the patient

Audit Risk Factors

  • Inadequate documentation of the type of spontaneous abortion
  • Failure to document the embolism's clinical significance
  • Lack of emotional support documentation
  • Misclassification of the abortion stage

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of the patient's obstetric history, including prior miscarriages, current pregnancy complications, and emotional support provided.

Common Clinical Scenarios

Patients presenting with bleeding and cramping in early pregnancy, confirmed spontaneous abortion, and subsequent embolic events.

Billing Considerations

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

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including maternal health conditions that may contribute to spontaneous abortion and embolism.

Common Clinical Scenarios

Management of patients with a history of recurrent pregnancy loss and associated complications.

Billing Considerations

Focus on the management of high-risk pregnancies and the implications of embolism on maternal and fetal health.

Coding Guidelines

Inclusion Criteria

Use O03.7 When
  • Follow the official ICD
  • CM coding guidelines for obstetric conditions, ensuring that the coding reflects the clinical scenario accurately
  • Document the type of spontaneous abortion and any complications such as embolism clearly

Exclusion Criteria

Do NOT use O03.7 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59820CPT Code

Dilation and curettage (D&C)

Clinical Scenario

Performed after a spontaneous abortion to remove retained products of conception.

Documentation Requirements

Document the indication for the procedure and any complications encountered.

Specialty Considerations

Ensure that the procedure is linked to the appropriate diagnosis code.

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 ability to capture complications such as embolism following spontaneous abortion, which enhances data accuracy and patient care tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the ability to capture complications such as embolism following spontaneous abortion, which enhances data accuracy and patient care tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the ability to capture complications such as embolism following spontaneous abortion, which enhances data accuracy and patient care tracking.

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 to support the use of code O03.7?

Documentation should include the type of spontaneous abortion, any complications such as embolism, the patient's clinical status, and details of emotional support provided. Clear linkage between diagnosis and any procedures performed is essential.