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ICD-10 Guide
ICD-10 CodesO04.7

O04.7

Billable

Embolism following (induced) termination of pregnancy

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

Code Description

ICD-10 O04.7 is a billable code used to indicate a diagnosis of embolism following (induced) termination of pregnancy.

Key Diagnostic Point:

Embolism following an induced termination of pregnancy refers to the occurrence of an embolic event, such as pulmonary embolism or venous thromboembolism, that arises as a complication after a medical or surgical abortion. This condition can occur due to various factors, including changes in coagulation status, immobility, or underlying health conditions that predispose the patient to thromboembolic events. Medical abortions, which involve the use of medications to terminate a pregnancy, can also lead to complications if not monitored properly. Therapeutic terminations, performed for medical reasons, may carry additional risks depending on the patient's health status. Post-abortion care is crucial in monitoring for signs of complications, including embolism, and ensuring that patients receive appropriate follow-up care to mitigate risks. Clinicians must be vigilant in assessing patients for symptoms such as chest pain, shortness of breath, or swelling in the extremities, which may indicate an embolic event. Accurate coding of this condition is essential for proper documentation and reimbursement, as well as for tracking complications associated with pregnancy termination.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of embolism (e.g., pulmonary vs. venous)
  • Understanding the clinical context of termination (medical vs. surgical)
  • Identifying risk factors for embolism in individual patients
  • Documenting the timeline of events post-termination

Audit Risk Factors

  • Inadequate documentation of the termination procedure
  • Failure to document pre-existing conditions that may contribute to embolism
  • Lack of follow-up notes indicating monitoring for complications
  • Misclassification of the type of embolism

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of the procedure performed, patient history, and any complications encountered during or after the termination.

Common Clinical Scenarios

Patients presenting with complications post-abortion, including signs of embolism.

Billing Considerations

Consideration of the patient's overall health, history of thromboembolic events, and the type of termination performed.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including maternal comorbidities and the rationale for therapeutic termination.

Common Clinical Scenarios

Management of high-risk pregnancies where termination is indicated due to maternal health concerns.

Billing Considerations

In-depth assessment of maternal-fetal risks and the implications of termination on both mother and fetus.

Coding Guidelines

Inclusion Criteria

Use O04.7 When
  • According to ICD
  • 10 coding guidelines, O04
  • 7 should be used when there is clear documentation of an embolic event following an induced termination of pregnancy
  • Coders must ensure that the timing and nature of the embolism are well
  • documented to support the use of this code

Exclusion Criteria

Do NOT use O04.7 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

58661CPT Code

Endometrial aspiration

Clinical Scenario

Used in cases of incomplete abortion or post-abortion complications.

Documentation Requirements

Documentation of the procedure performed and indication for aspiration.

Specialty Considerations

Obstetricians must ensure that the procedure is well-documented to support coding.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of complications following termination of pregnancy, improving the ability to track and manage these conditions. O04.7 provides a clear designation for embolism, which aids in clinical management and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of complications following termination of pregnancy, improving the ability to track and manage these conditions. O04.7 provides a clear designation for embolism, which aids in clinical management and research.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of complications following termination of pregnancy, improving the ability to track and manage these conditions. O04.7 provides a clear designation for embolism, which aids in clinical management and research.

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 common signs of embolism following termination of pregnancy?

Common signs include sudden shortness of breath, chest pain, rapid heart rate, and swelling in the legs. Patients should be monitored closely for these symptoms in the post-abortion period.