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v1.0.0
ICD-10 Guide
ICD-10 CodesO03.85

O03.85

Billable

Other venous complications following complete or unspecified spontaneous abortion

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

Code Description

ICD-10 O03.85 is a billable code used to indicate a diagnosis of other venous complications following complete or unspecified spontaneous abortion.

Key Diagnostic Point:

O03.85 refers to venous complications that may arise following a complete or unspecified spontaneous abortion, commonly known as miscarriage. A spontaneous abortion is defined as the natural termination of a pregnancy before the fetus can live independently outside the womb, typically occurring before the 20th week of gestation. The condition can lead to various complications, including venous thromboembolism, which may manifest as deep vein thrombosis (DVT) or pulmonary embolism (PE). These complications can arise due to changes in blood coagulation and venous stasis that occur during and after pregnancy. Emotional support is crucial for patients experiencing spontaneous abortion, as they may face significant psychological distress. Healthcare providers should ensure that patients receive appropriate counseling and follow-up care to address both physical and emotional health needs. Understanding the stages of miscarriage, including early pregnancy loss and the importance of cervical competence, is essential for accurate diagnosis and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between complete and incomplete spontaneous abortion
  • Identifying specific venous complications related to the abortion
  • Understanding the patient's obstetric history and risk factors
  • Documenting emotional and psychological support provided

Audit Risk Factors

  • Inadequate documentation of the type of spontaneous abortion
  • Failure to document venous complications clearly
  • Lack of emotional support documentation
  • Misclassification of the abortion type

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with signs of miscarriage, requiring assessment for complications such as DVT or PE.

Billing Considerations

Ensure accurate coding of both the abortion and any complications, as well as the emotional impact on the patient.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including maternal age, medical history, and any prior pregnancy complications.

Common Clinical Scenarios

Management of patients with a history of recurrent miscarriages or those presenting with complications following a spontaneous abortion.

Billing Considerations

Focus on the management of both maternal and fetal health, ensuring all complications are documented.

Coding Guidelines

Inclusion Criteria

Use O03.85 When
  • Follow the official ICD
  • CM guidelines for coding obstetric conditions, ensuring that all relevant details about the spontaneous abortion and any complications are documented
  • Use additional codes as necessary to capture the full clinical picture

Exclusion Criteria

Do NOT use O03.85 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 during pregnancy, including follow-up after a spontaneous abortion.

Documentation Requirements

Document all visits and any complications or emotional support provided.

Specialty Considerations

Ensure that all aspects of care are captured, including emotional and psychological support.

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 like those associated with spontaneous abortion. This specificity aids in better patient management and resource allocation.

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 like those associated with spontaneous abortion. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the ability to capture complications like those associated with spontaneous abortion. This specificity aids in better patient management and resource allocation.

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 I document when coding O03.85?

Document the type of spontaneous abortion, any venous complications, and the emotional support provided to the patient. Ensure that all clinical details are captured to support the coding.