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ICD-10 Guide
ICD-10 CodesO03.87

O03.87

Billable

Sepsis following complete or unspecified spontaneous abortion

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

Code Description

ICD-10 O03.87 is a billable code used to indicate a diagnosis of sepsis following complete or unspecified spontaneous abortion.

Key Diagnostic Point:

Sepsis following a spontaneous abortion, whether complete or unspecified, is a serious condition that arises when the body responds to an infection after the loss of a pregnancy. Spontaneous abortion, commonly referred to as miscarriage, can occur at various stages of pregnancy, typically before the 20th week. The condition can be classified into complete, where all pregnancy tissue is expelled, and incomplete, where some tissue remains. Cervical competence plays a crucial role in maintaining pregnancy; its failure can lead to miscarriage. Emotional support is vital for patients experiencing spontaneous abortion, as it can be a traumatic event. The risk of sepsis increases if there is retained tissue or infection following the abortion, necessitating prompt medical intervention. Symptoms of sepsis may include fever, chills, rapid heart rate, and confusion. Proper coding of this condition is essential for accurate medical records and appropriate treatment pathways.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between complete and incomplete spontaneous abortion
  • Identifying the presence of infection and its severity
  • Understanding the patient's obstetric history and risk factors
  • Documenting emotional and psychological support provided

Audit Risk Factors

  • Inadequate documentation of the type of abortion
  • Failure to document signs of infection
  • Lack of clarity on the treatment provided
  • Insufficient emotional support documentation

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of the patient's obstetric history, type of abortion, and any complications.

Common Clinical Scenarios

Patients presenting with bleeding, cramping, and signs of infection post-abortion.

Billing Considerations

Consider the emotional impact on the patient and document any counseling or support provided.

Maternal-Fetal Medicine

Documentation Requirements

Thorough documentation of high-risk factors and any interventions performed.

Common Clinical Scenarios

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

Billing Considerations

Focus on the implications of sepsis on maternal health and potential future pregnancies.

Coding Guidelines

Inclusion Criteria

Use O03.87 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the abortion type and any complications such as sepsis
  • Ensure that the clinical context supports the diagnosis

Exclusion Criteria

Do NOT use O03.87 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59820CPT Code

Surgical evacuation of the uterus following spontaneous abortion

Clinical Scenario

Used when a patient requires surgical intervention due to retained products of conception after a spontaneous abortion.

Documentation Requirements

Document the indication for surgery, findings during the procedure, and any complications.

Specialty Considerations

Ensure that the surgical procedure is linked to the diagnosis of sepsis if applicable.

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 diagnoses such as sepsis following spontaneous abortion, which can lead to better patient management and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the accuracy of diagnoses such as sepsis following spontaneous abortion, which can lead to better patient management and outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, improving the accuracy of diagnoses such as sepsis following spontaneous abortion, which can lead to better patient management and outcomes.

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 are the signs of sepsis following a spontaneous abortion?

Signs of sepsis may include fever, chills, rapid heart rate, confusion, and severe abdominal pain. Prompt recognition and treatment are crucial.