2025 ICD-10-CM code O03.3
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Pregnancy with abortive outcome - Spontaneous abortion, incomplete Chapter 15: Pregnancy, childbirth and the puerperium (O00-O9A) Feed
Other and unspecified complications following incomplete spontaneous abortion.
Not applicable to ICD-10 codes.
Medical necessity is established by the presence of an incomplete spontaneous abortion with complications requiring medical or surgical intervention. Documentation must clearly support the medical necessity of procedures or treatments administered.
The clinical responsibility depends on the specific complications encountered.This could involve the obstetrician/gynecologist, other specialists (e.g., infectious disease, hematology), and support staff (e.g., nurses, technicians).
- Chapter 15: Pregnancy, childbirth and the puerperium (O00-O9A)
- O00-O08: Pregnancy with abortive outcome
In simple words: This code is for a miscarriage where some pregnancy tissue remains in the uterus and other problems occur that aren't specifically listed.
This code is used to classify instances of incomplete spontaneous abortion where complications arise that are not specifically defined or categorized elsewhere.It encompasses a range of potential issues occurring after an incomplete miscarriage, excluding those specifically detailed by other codes within the O03 series (e.g., infection, hemorrhage, embolism).
Example 1: A patient presents with incomplete spontaneous abortion with retained products of conception and heavy bleeding that doesn't respond to medication management.Additional surgical intervention is required., A patient experiences an incomplete miscarriage, and subsequent development of a pelvic infection requiring intravenous antibiotics and close monitoring., A patient has an incomplete spontaneous abortion with unknown complications leading to the need for additional diagnostic imaging and follow-up care to determine the underlying cause.
Complete patient history, physical examination findings, results of diagnostic tests (e.g., blood work, ultrasound, imaging), details of all treatments administered, and any complications encountered should be thoroughly documented.Documentation should justify the medical necessity of services rendered.
** This code is for use only on maternal records, never on newborn records.Always consider the full clinical picture when selecting this code.Use additional codes from category Z3A (Weeks of gestation) if known.
- Revenue Code: Revenue codes will vary depending on the specific services rendered and the payer.Consult local coding guidelines and payer-specific information for appropriate revenue codes.
- RVU: RVUs are not directly assigned to ICD-10 codes. Reimbursement is based on the procedures and services performed to manage the complications, which will be coded using CPT or HCPCS codes, then RVUs will be applied based on the CPT/HCPCS codes.
- Global Days: Not applicable to ICD-10 codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes. Reimbursement is based on the procedures and services performed, using CPT or HCPCS codes, which have associated fee schedules.
- Specialties:Obstetrics and Gynecology
- Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center