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v1.0.0
ICD-10 Guide
ICD-10 CodesO04.89

O04.89

Billable

(Induced) termination of pregnancy with other complications

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

Code Description

ICD-10 O04.89 is a billable code used to indicate a diagnosis of (induced) termination of pregnancy with other complications.

Key Diagnostic Point:

O04.89 refers to the induced termination of pregnancy that occurs with other complications not specified elsewhere. This code is utilized in cases where a medical abortion or therapeutic termination is performed due to various complications such as maternal health risks, fetal anomalies, or psychosocial factors. Medical abortions may involve the use of medications like mifepristone and misoprostol, while therapeutic terminations may be indicated for severe maternal conditions such as preeclampsia or gestational diabetes that pose risks to the mother or fetus. Post-abortion care is critical, involving monitoring for complications such as infection, excessive bleeding, or incomplete abortion. Proper documentation of the indications for termination, the method used, and any complications encountered is essential for accurate coding and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of indications for termination (medical, therapeutic, elective)
  • Need for detailed documentation of complications
  • Differentiation between types of abortion (medical vs. surgical)
  • Potential for co-existing conditions affecting coding

Audit Risk Factors

  • Inadequate documentation of complications
  • Misclassification of the type of termination
  • Failure to document patient consent and counseling
  • Inconsistent coding of co-existing conditions

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include the reason for termination, method used, and any complications encountered during the procedure.

Common Clinical Scenarios

Indications for termination due to maternal health risks, fetal anomalies, or psychosocial factors.

Billing Considerations

Ensure all relevant clinical details are captured to support the use of O04.89.

Maternal-Fetal Medicine

Documentation Requirements

Detailed documentation of high-risk factors and maternal-fetal assessments leading to the decision for termination.

Common Clinical Scenarios

Complex cases involving severe maternal conditions or significant fetal anomalies.

Billing Considerations

Consider the implications of high-risk factors on coding and reimbursement.

Coding Guidelines

Inclusion Criteria

Use O04.89 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the documentation supports the diagnosis and procedure codes used
  • Specific criteria for complications must be met to justify the use of O04

Exclusion Criteria

Do NOT use O04.89 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59840CPT Code

Medical abortion, with or without dilation and curettage

Clinical Scenario

Used when a medical abortion is performed with complications.

Documentation Requirements

Document the method of abortion and any complications encountered.

Specialty Considerations

Obstetricians should ensure that all clinical details are captured for accurate coding.

59841CPT Code

Surgical abortion, aspiration curettage

Clinical Scenario

Used for surgical termination with complications.

Documentation Requirements

Document the surgical procedure and any complications.

Specialty Considerations

Ensure compliance with facility protocols for surgical procedures.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of complications associated with pregnancy termination, improving the accuracy of claims and facilitating better patient care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of complications associated with pregnancy termination, improving the accuracy of claims and facilitating better patient care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of complications associated with pregnancy termination, improving the accuracy of claims and facilitating better patient care.

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 O04.89?

Documentation must include the reason for termination, the method used, any complications encountered, and follow-up care provided. Ensure that all clinical details are captured to support the use of this code.