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ICD-10 Guide
ICD-10 CodesO04.81

O04.81

Billable

Shock following (induced) termination of pregnancy

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

Code Description

ICD-10 O04.81 is a billable code used to indicate a diagnosis of shock following (induced) termination of pregnancy.

Key Diagnostic Point:

Shock following an induced termination of pregnancy is a serious obstetric condition that can arise due to various complications during or after the procedure. Medical abortions, whether pharmacological or surgical, can lead to significant physiological changes and potential complications, including hemorrhage, infection, or anaphylactic reactions to medications. The onset of shock may manifest as hypotension, tachycardia, altered mental status, and other signs of inadequate perfusion. It is crucial for healthcare providers to monitor patients closely during the post-abortion period, as early recognition and intervention can be life-saving. Therapeutic terminations, often performed for maternal health reasons, require careful consideration of the patient's medical history and current health status. Post-abortion care should include thorough assessment and management of any complications, ensuring that patients receive appropriate follow-up care to address both physical and emotional health needs.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between types of termination (medical vs. surgical)
  • Identifying the cause of shock (e.g., hemorrhage, infection)
  • Documenting the patient's medical history and risk factors
  • Understanding the nuances of post-abortion care and follow-up

Audit Risk Factors

  • Inadequate documentation of the reason for termination
  • Failure to document the patient's vital signs and clinical status post-procedure
  • Lack of follow-up care documentation
  • Misclassification of the type of termination performed

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include the indication for termination, type of procedure performed, and any complications encountered. Vital signs and assessments during recovery are critical.

Common Clinical Scenarios

Patients presenting for medical abortion, surgical termination, or experiencing complications such as hemorrhage or infection post-abortion.

Billing Considerations

Coders must be aware of the legal implications and ensure that documentation supports the medical necessity of the procedure.

Maternal-Fetal Medicine

Documentation Requirements

Detailed documentation of maternal and fetal health, including any pre-existing conditions that may complicate the termination process.

Common Clinical Scenarios

High-risk patients requiring therapeutic termination due to severe maternal health issues or fetal anomalies.

Billing Considerations

High-risk scenarios necessitate thorough documentation of the decision-making process and the rationale for the chosen method of termination.

Coding Guidelines

Inclusion Criteria

Use O04.81 When
  • According to official coding guidelines, O04
  • 81 should be used when a patient experiences shock following an induced termination of pregnancy
  • Coders must ensure that the documentation supports the diagnosis and reflects the clinical scenario accurately

Exclusion Criteria

Do NOT use O04.81 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59840CPT Code

Medical abortion, by medication

Clinical Scenario

Used when a patient undergoes a medical abortion and experiences complications.

Documentation Requirements

Documentation must include the type of medication used, dosage, and any adverse reactions.

Specialty Considerations

Obstetricians must ensure that all aspects of care are documented, especially in cases of complications.

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 accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of complications following termination of pregnancy, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What documentation is required for coding O04.81?

Documentation must include the indication for the termination, details of the procedure performed, any complications experienced, and follow-up care provided. Vital signs and clinical assessments during recovery are critical to support the diagnosis of shock.