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ICD-10 Guide
ICD-10 CodesO04.87

O04.87

Billable

Sepsis following (induced) termination of pregnancy

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

Code Description

ICD-10 O04.87 is a billable code used to indicate a diagnosis of sepsis following (induced) termination of pregnancy.

Key Diagnostic Point:

Sepsis following an induced termination of pregnancy is a serious condition that can arise when an infection occurs after a medical or surgical abortion. This condition is characterized by systemic inflammatory response syndrome (SIRS) due to infection, which can lead to organ dysfunction and potentially life-threatening complications. The risk of sepsis can be heightened by factors such as the method of termination (medical vs. surgical), the gestational age at the time of the procedure, and the presence of any underlying health conditions in the patient. Post-abortion care is crucial, as it involves monitoring for signs of infection, such as fever, chills, and abdominal pain. Proper clinical management includes timely diagnosis, initiation of broad-spectrum antibiotics, and supportive care. Coders must ensure accurate documentation of the termination method, any complications, and the patient's clinical status to appropriately assign this code.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between medical and surgical abortion methods
  • Identifying signs and symptoms of sepsis in postpartum patients
  • Understanding the timeline of complications following termination
  • Documenting co-existing conditions that may influence coding

Audit Risk Factors

  • Inadequate documentation of the termination method
  • Failure to document signs of infection or sepsis
  • Misclassification of the timing of the procedure
  • Omission of relevant patient history or comorbidities

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include the method of termination, any complications, and follow-up care provided.

Common Clinical Scenarios

Patients presenting with fever and abdominal pain post-abortion, requiring evaluation for sepsis.

Billing Considerations

Coders should be aware of the legal and ethical implications surrounding abortion procedures.

Maternal-Fetal Medicine

Documentation Requirements

Detailed documentation of maternal health status and any high-risk factors that may contribute to complications.

Common Clinical Scenarios

High-risk patients undergoing termination who may have pre-existing conditions affecting their recovery.

Billing Considerations

Consideration of the patient's overall health and potential for complications is critical in coding.

Coding Guidelines

Inclusion Criteria

Use O04.87 When
  • According to ICD
  • 10 coding guidelines, O04
  • 87 should be used when sepsis is confirmed following an induced termination of pregnancy
  • Coders must ensure that the diagnosis is supported by clinical documentation and that all relevant details are captured

Exclusion Criteria

Do NOT use O04.87 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59840CPT Code

Medical abortion, including counseling

Clinical Scenario

Used when a patient undergoes a medical abortion and later presents with complications.

Documentation Requirements

Documentation of the procedure, patient consent, and any complications encountered.

Specialty Considerations

Obstetricians should ensure thorough documentation of the medical abortion process.

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

  • •
    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 needed to support the use of O04.87?

Documentation must include the method of termination, any signs of infection, clinical findings, and treatment provided. Clear notes on the patient's condition and follow-up care are essential.