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2025 ICD-10-CM code O03.38

Urinary tract infection following an incomplete spontaneous abortion.

This code should only be used in maternal records, never on newborn records. It should be used only when the UTI is directly related to the incomplete spontaneous abortion.

The UTI is considered medically necessary if it's a direct complication of the incomplete spontaneous abortion, as evidenced by the timing of the infection relative to the abortion and supporting clinical findings.

Obstetrician-Gynecologist, family medicine physician, or other qualified healthcare provider managing the pregnancy and postpartum care.

IMPORTANT:Consider additional codes from category Z3A (Weeks of gestation) to specify the gestational age if known.Other complications of incomplete spontaneous abortion (O03.30-O03.39) may need to be coded in addition to O03.38 depending on the specific circumstances.

In simple words: This code is used when a woman has a miscarriage where some pregnancy tissue remains in her body and she develops a bladder or urinary tract infection as a result.

This code classifies a urinary tract infection (UTI) that occurs as a complication following an incomplete spontaneous abortion (miscarriage).An incomplete abortion is defined as a miscarriage where some products of conception remain in the uterus. The UTI is considered a direct consequence of the incomplete abortion.

Example 1: A 28-year-old female presents to the emergency department with symptoms of a UTI (dysuria, frequency, urgency) following a recent miscarriage where some tissue was retained in the uterus.Ultrasound confirms retained products of conception, and urine analysis reveals a UTI., A 35-year-old woman experiences an incomplete spontaneous abortion at 8 weeks gestation.During a follow-up visit, she reports symptoms consistent with a UTI.Urine culture confirms bacterial infection., A 25-year-old patient undergoes a D&C procedure for an incomplete spontaneous abortion. Post-procedure, she develops a fever and urinary symptoms.A UTI is diagnosed, requiring antibiotic treatment.

Complete medical history including details of the spontaneous abortion (date, gestational age, management), physical examination findings, laboratory results (urine analysis, urine culture), and any imaging studies (ultrasound).

** This code is used to describe a specific complication following an incomplete spontaneous abortion.Accurate documentation is crucial to ensure proper coding and billing.

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