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ICD-10 Guide
ICD-10 CodesO03.86

O03.86

Billable

Cardiac arrest following complete or unspecified spontaneous abortion

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

Code Description

ICD-10 O03.86 is a billable code used to indicate a diagnosis of cardiac arrest following complete or unspecified spontaneous abortion.

Key Diagnostic Point:

Cardiac arrest following a spontaneous abortion, whether complete or unspecified, is a critical obstetric condition that can arise due to various complications during pregnancy loss. Spontaneous abortion, commonly referred to as miscarriage, can occur in the early stages of pregnancy, typically before the 20th week. The emotional and physical toll on the patient can be significant, and in some cases, complications such as severe hemorrhage or infection may lead to cardiac arrest. The management of such cases requires immediate medical intervention, including resuscitation efforts and stabilization of the patient. Understanding the stages of miscarriage, including the role of cervical competence and the potential for retained products of conception, is essential for healthcare providers. Emotional support is also a crucial component of care, as patients may experience profound grief and loss. Proper documentation of the circumstances surrounding the cardiac arrest, including any pre-existing conditions and the timeline of events leading to the abortion, is vital for accurate coding and billing.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between complete and incomplete spontaneous abortion.
  • Identifying the cause of cardiac arrest in the context of pregnancy loss.
  • Documenting emotional and psychological support provided to the patient.
  • Understanding the implications of cervical incompetence and its role in miscarriage.

Audit Risk Factors

  • Inadequate documentation of the patient's clinical status prior to cardiac arrest.
  • Failure to specify whether the abortion was complete or incomplete.
  • Lack of detail regarding the management and interventions performed.
  • Insufficient emotional support documentation.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of the patient's obstetric history, current pregnancy status, and any complications encountered during the abortion process.

Common Clinical Scenarios

Patients presenting with heavy bleeding, severe abdominal pain, or signs of infection following a spontaneous abortion.

Billing Considerations

Consideration of the patient's emotional state and the provision of psychological support services.

Maternal-Fetal Medicine

Documentation Requirements

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

Common Clinical Scenarios

Management of patients with a history of recurrent pregnancy loss or those presenting with complications during a spontaneous abortion.

Billing Considerations

Focus on the management of high-risk pregnancies and the potential for severe outcomes, including cardiac arrest.

Coding Guidelines

Inclusion Criteria

Use O03.86 When
  • According to official coding guidelines, O03
  • 86 should be used when a patient experiences cardiac arrest following a spontaneous abortion
  • Coders must ensure that all relevant clinical details are documented, including the timing of the abortion and any complications that arose

Exclusion Criteria

Do NOT use O03.86 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99285CPT Code

Emergency department visit, high severity

Clinical Scenario

Used when a patient presents with cardiac arrest following a spontaneous abortion.

Documentation Requirements

Detailed documentation of the patient's condition upon arrival and interventions performed.

Specialty Considerations

Emergency medicine specialists must document the urgency and nature of the care provided.

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 the ability to capture complications such as cardiac arrest following spontaneous abortion. This specificity aids in better tracking of outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including the ability to capture complications such as cardiac arrest following spontaneous abortion. This specificity aids in better tracking of outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including the ability to capture complications such as cardiac arrest following spontaneous abortion. This specificity aids in better tracking of outcomes and resource allocation.

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 O03.86?

Documentation should include the patient's clinical presentation, the type of spontaneous abortion, any complications leading to cardiac arrest, and the interventions performed. Emotional support provided should also be noted.