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ICD-10 Guide
ICD-10 CodesChapter 15: Pregnancy, childbirth and the puerperiumO07

O07

Non-billable

Failed attempted termination of pregnancy

Chapter 15:Pregnancy, childbirth and the puerperium

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 O07 is a used to indicate a diagnosis of failed attempted termination of pregnancy.

Key Diagnostic Point:

The ICD-10 code O07 refers to 'Failed attempted termination of pregnancy,' which encompasses instances where a procedure intended to terminate a pregnancy does not achieve the desired outcome. This category is significant as it highlights the clinical scenarios where patients may experience complications or incomplete procedures following an abortion attempt. It is essential for healthcare providers to accurately document these cases to ensure appropriate follow-up care and management, as well as to inform future reproductive health decisions for the patient. The clinical significance of this code lies in its ability to capture the complexities surrounding attempted terminations, which may involve various medical, surgical, or pharmacological interventions that did not succeed as planned.

  • Usage guidelines for O07 indicate that it should be applied when there is clear documentation of a failed termination attempt, regardless of the method used. This includes situations where the patient may have undergone a medical abortion that did not result in the complete expulsion of the pregnancy tissue or surgical procedures that did not achieve the intended outcome. Accurate coding is critical not only for patient care but also for statistical reporting and resource allocation within healthcare systems, which can influence policy and funding for reproductive health services.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation
  • Need for precise clinical details
  • Potential for overlapping codes

Audit Risk Factors

  • Inadequate documentation of the procedure
  • Misuse of related codes
  • Failure to capture patient follow-up care

Specialty Focus

Medical Specialties

Obstetrics

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Gynecology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical and administrative impact of the O07 code category is significant, as it directly affects quality measures related to reproductive health services. Accurate coding of failed termination attempts can provide valuable data for healthcare systems, helping to identify trends in patient outcomes and the effectiveness of various termination methods. This information can be crucial for improving patient care protocols and ensuring that women receive the appropriate follow-up care after a failed procedure.
From a population health perspective, understanding the implications of O07 can aid in addressing broader healthcare trends, such as access to safe and effective reproductive health services. As healthcare policies continue to evolve, the ability to track and analyze data related to failed terminations can inform advocacy efforts and resource allocation, ultimately contributing to improved health outcomes for women and families.

ICD-9 vs ICD-10

The clinical and administrative impact of the O07 code category is significant, as it directly affects quality measures related to reproductive health services. Accurate coding of failed termination attempts can provide valuable data for healthcare systems, helping to identify trends in patient outcomes and the effectiveness of various termination methods. This information can be crucial for improving patient care protocols and ensuring that women receive the appropriate follow-up care after a failed procedure. From a population health perspective, understanding the implications of O07 can aid in addressing broader healthcare trends, such as access to safe and effective reproductive health services. As healthcare policies continue to evolve, the ability to track and analyze data related to failed terminations can inform advocacy efforts and resource allocation, ultimately contributing to improved health outcomes for women and families.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the payer, and it is essential to check specific guidelines for coding failed terminations, as some insurers may have particular requirements for claims submissions. Common billing practices involve using modifiers to indicate the nature of the service provided, especially if follow-up procedures were necessary due to the failed termination.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for O07

Coding & Billing References

  • •
    Official ICD-10 Guidelines for O07

Frequently Asked Questions

What conditions are included in O07?

O07 includes cases where an attempted termination of pregnancy has failed, such as incomplete abortions, retained products of conception, or unsuccessful medical abortion attempts.

When should I use O07 codes?

O07 codes should be used when there is documentation of a failed termination attempt, indicating that the procedure did not achieve its intended outcome and further medical intervention may be necessary.

What documentation is required for O07?

Documentation should include details of the attempted termination procedure, the method used, clinical findings, and any subsequent treatment or follow-up care provided to the patient.