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ICD-10 Guide
ICD-10 CodesO04.86

O04.86

Billable

Cardiac arrest following (induced) termination of pregnancy

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

Code Description

ICD-10 O04.86 is a billable code used to indicate a diagnosis of cardiac arrest following (induced) termination of pregnancy.

Key Diagnostic Point:

Cardiac arrest following an induced termination of pregnancy is a rare but critical obstetric emergency that can occur due to various factors, including complications from the procedure itself or underlying maternal health conditions. Induced termination of pregnancy can be performed through medical abortion, which involves the use of medications to terminate a pregnancy, or surgical methods, such as dilation and curettage (D&C). In some cases, patients may experience severe complications such as hemorrhage, infection, or anaphylactic reactions to medications, which can lead to cardiac arrest. Post-abortion care is essential to monitor for these complications and ensure the patient's recovery. Healthcare providers must be vigilant in assessing the patient's vital signs and overall health status during and after the procedure. Proper documentation of the patient's medical history, the method of termination, and any complications encountered is crucial for accurate coding and billing. This code is particularly important in cases where the cardiac arrest is directly linked to the termination procedure, emphasizing the need for thorough clinical evaluation and follow-up care.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between medical and surgical abortion complications
  • Understanding the nuances of cardiac arrest causes in obstetric patients
  • Documenting the timeline and details of the termination procedure
  • Identifying co-existing medical conditions that may contribute to cardiac arrest

Audit Risk Factors

  • Inadequate documentation of the procedure and complications
  • Failure to link the cardiac arrest directly to the termination of pregnancy
  • Misclassification of the type of termination performed
  • Lack of follow-up documentation post-procedure

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with complications post-abortion, including hemorrhage or infection.

Billing Considerations

Consideration of the patient's mental health and counseling needs post-termination.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including pre-existing conditions and complications during pregnancy.

Common Clinical Scenarios

Management of patients with significant comorbidities undergoing termination.

Billing Considerations

Close monitoring of maternal health and fetal conditions, if applicable.

Coding Guidelines

Inclusion Criteria

Use O04.86 When
  • According to ICD
  • 10 coding guidelines, O04
  • 86 should be used when there is a clear clinical link between the cardiac arrest and the induced termination of pregnancy
  • Coders must ensure that all relevant documentation supports the diagnosis and that any associated complications are accurately captured

Exclusion Criteria

Do NOT use O04.86 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59840CPT Code

Medical abortion, medication administration

Clinical Scenario

Used when a patient receives medication for abortion and experiences complications.

Documentation Requirements

Documentation of the medication administered and patient monitoring.

Specialty Considerations

Obstetricians must ensure thorough follow-up care is documented.

59841CPT Code

Surgical abortion, dilation and curettage

Clinical Scenario

Used when a surgical procedure is performed and complications arise.

Documentation Requirements

Detailed notes on the surgical procedure and any complications encountered.

Specialty Considerations

Surgeons must document the surgical technique and any intraoperative findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of complications related to termination of pregnancy, enhancing the ability to capture the nuances of patient care and outcomes. This specificity aids in better tracking of complications and improving patient safety measures.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of complications related to termination of pregnancy, enhancing the ability to capture the nuances of patient care and outcomes. This specificity aids in better tracking of complications and improving patient safety measures.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of complications related to termination of pregnancy, enhancing the ability to capture the nuances of patient care and outcomes. This specificity aids in better tracking of complications and improving patient safety measures.

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 documentation is required for coding O04.86?

Documentation must include the type of termination performed, any complications experienced during or after the procedure, and a clear link between the cardiac arrest and the termination. Additionally, any pre-existing conditions that may have contributed to the cardiac arrest should be documented.