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ICD-10 Guide
ICD-10 CodesO07.0

O07.0

Billable

Genital tract and pelvic infection following failed attempted termination of pregnancy

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

Code Description

ICD-10 O07.0 is a billable code used to indicate a diagnosis of genital tract and pelvic infection following failed attempted termination of pregnancy.

Key Diagnostic Point:

O07.0 refers to infections of the genital tract and pelvis that occur after a failed attempted termination of pregnancy. This condition can arise when a woman undergoes a procedure intended to terminate a pregnancy, but the procedure is unsuccessful, leading to retained products of conception. The retained tissue can become infected, resulting in complications such as endometritis or pelvic inflammatory disease. Symptoms may include fever, abdominal pain, abnormal vaginal discharge, and tenderness upon examination. Management typically involves antibiotic therapy, and in some cases, surgical intervention may be necessary to remove retained tissue. It is crucial for healthcare providers to monitor for signs of infection and provide appropriate follow-up care to prevent further complications. Accurate coding of this condition is essential for proper treatment and reimbursement, as it reflects the complexity of care required for patients experiencing complications from failed terminations.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between types of infections (e.g., endometritis vs. pelvic inflammatory disease)
  • Understanding the clinical implications of retained products of conception
  • Navigating documentation requirements for failed terminations
  • Identifying associated complications that may arise post-procedure

Audit Risk Factors

  • Inadequate documentation of the attempted termination procedure
  • Failure to document the specific type of infection
  • Lack of follow-up notes indicating resolution or ongoing issues
  • Misclassification of the infection severity

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of the patient's history, the procedure performed, and any complications encountered is essential. Notes should include the patient's symptoms, examination findings, and treatment plan.

Common Clinical Scenarios

Patients presenting with fever and abdominal pain after a failed termination, requiring evaluation for infection.

Billing Considerations

Coders must be aware of the nuances in documentation that differentiate between types of infections and their management.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive records of maternal health, fetal status, and any interventions performed during high-risk pregnancies are crucial.

Common Clinical Scenarios

High-risk patients experiencing complications from failed terminations, necessitating specialized care.

Billing Considerations

Attention to maternal-fetal interactions and the implications of infections on both maternal and fetal health.

Coding Guidelines

Inclusion Criteria

Use O07.0 When
  • According to ICD
  • 10 coding guidelines, O07
  • 0 should be used when a genital tract or pelvic infection is specifically linked to a failed termination of pregnancy
  • Coders must ensure that the diagnosis is supported by clinical documentation and that any associated procedures are accurately captured

Exclusion Criteria

Do NOT use O07.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

58120CPT Code

Dilation and curettage (D&C)

Clinical Scenario

Used in cases of retained products of conception following a failed termination.

Documentation Requirements

Documentation must include indications for the procedure and any findings during the D&C.

Specialty Considerations

Obstetricians should document the reason for the procedure clearly to support coding.

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 failed terminations, improving the accuracy of patient records and reimbursement processes. O07.0 provides a clear distinction for infections that arise specifically from these situations.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of complications related to failed terminations, improving the accuracy of patient records and reimbursement processes. O07.0 provides a clear distinction for infections that arise specifically from these situations.

Reimbursement & Billing Impact

reimbursement processes. O07.0 provides a clear distinction for infections that arise specifically from these situations.

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 to support the use of code O07.0?

To support the use of code O07.0, documentation must include details of the attempted termination procedure, any complications that arose, clinical symptoms of infection, and the treatment plan. Follow-up notes indicating the patient's progress and resolution of symptoms are also essential.