2025 ICD-10-CM code O86.04
Sepsis following an obstetrical procedure.
Medical necessity for this code is established when a patient develops sepsis as a direct result of a recent obstetrical procedure, requiring treatment and management in a clinical setting.
The physician is responsible for diagnosing and treating sepsis after an obstetrical procedure, including administering antibiotics, fluids, and other supportive care.
- 15 Pregnancy, childbirth and the puerperium
- Complications predominantly related to the puerperium (O85-O92)
In simple words: A patient developed a serious infection throughout the body following a procedure related to childbirth.
Sepsis following an obstetrical procedure. Use additional code to identify the sepsis.
Example 1: A patient develops sepsis after a cesarean section., A patient develops sepsis after a vaginal delivery with episiotomy., A patient develops sepsis after a dilation and curettage (D&C) following a miscarriage.
Documentation should include signs and symptoms of sepsis such as fever, elevated heart rate, low blood pressure, and laboratory results indicating infection, details of the obstetrical procedure performed, and evidence of organ dysfunction if present.
** This code is used only on the maternal record, never on the newborn record. It describes a serious condition requiring prompt medical intervention.
- Payment Status: Active
- Specialties:Obstetrics and Gynecology, Maternal-Fetal Medicine, Infectious Disease
- Place of Service:Inpatient Hospital