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v1.0.0
ICD-10 Guide
ICD-10 CodesO03.80

O03.80

Billable

Unspecified complication following complete or unspecified spontaneous abortion

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

Code Description

ICD-10 O03.80 is a billable code used to indicate a diagnosis of unspecified complication following complete or unspecified spontaneous abortion.

Key Diagnostic Point:

O03.80 refers to unspecified complications that may arise following a complete or unspecified spontaneous abortion, commonly known as a miscarriage. A spontaneous abortion is defined as the natural loss of a pregnancy before the 20th week of gestation. Complications can include retained products of conception, infection, or excessive bleeding, which may require further medical intervention. The emotional impact of a miscarriage can also be significant, necessitating psychological support for the patient. It is crucial for healthcare providers to document the specifics of the abortion, including gestational age, any complications experienced, and the emotional support offered to the patient. This code is used when the specific complication is not detailed in the medical record, highlighting the importance of thorough documentation in obstetric care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of complications
  • Need for precise gestational age determination
  • Differentiation between complete and incomplete abortion
  • Emotional and psychological considerations

Audit Risk Factors

  • Inadequate documentation of complications
  • Failure to specify gestational age
  • Lack of emotional support documentation
  • Misclassification of abortion type (complete vs. incomplete)

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation should include details of the abortion, gestational age, any complications, and emotional support provided.

Common Clinical Scenarios

Patients presenting with bleeding or cramping following a spontaneous abortion, requiring follow-up care.

Billing Considerations

Ensure accurate coding based on the type of abortion and any complications; emotional support should be documented.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancies require detailed documentation of maternal and fetal health, including complications following spontaneous abortion.

Common Clinical Scenarios

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

Billing Considerations

Consideration of maternal health history and psychological support is critical in high-risk scenarios.

Coding Guidelines

Inclusion Criteria

Use O03.80 When
  • Follow official ICD
  • 10 guidelines for obstetric coding, ensuring that all relevant details of the spontaneous abortion and any complications are documented
  • Use additional codes as necessary to capture the full clinical picture

Exclusion Criteria

Do NOT use O03.80 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 when managing a patient who has experienced a spontaneous abortion and requires comprehensive care.

Documentation Requirements

Document all aspects of care, including emotional support and follow-up.

Specialty Considerations

Obstetricians should ensure that all care provided is well-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 data collection and reimbursement processes. O03.80 provides a clear framework for documenting complications following 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 data collection and reimbursement processes. O03.80 provides a clear framework for documenting complications following spontaneous abortion.

Reimbursement & Billing Impact

reimbursement processes. O03.80 provides a clear framework for documenting complications following 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 when coding O03.80?

Documentation should include the type of spontaneous abortion, any complications experienced, gestational age, and details of emotional support provided to the patient.