2025 ICD-10-CM code O03.87
Sepsis following complete or unspecified spontaneous abortion.
Medical necessity is established by the presence of sepsis, a life-threatening condition, following a spontaneous abortion. The documentation must support the diagnosis of sepsis and its connection to the prior miscarriage.
The physician managing the patient's care during and after the miscarriage is responsible for assigning this code. This usually involves obstetricians, gynecologists, or other healthcare professionals involved in maternal care.
- Chapter 15: Pregnancy, childbirth and the puerperium (O00-O9A)
- Pregnancy with abortive outcome (O00-O08)
In simple words: This code indicates a life-threatening infection (sepsis) following a miscarriage where either all pregnancy tissue has been expelled or the specific stage of the miscarriage is not known.
Sepsis following a complete or unspecified spontaneous abortion (miscarriage). This code should be used on the maternal record only.Use additional code to identify the infectious agent (B95-B97) and to identify severe sepsis, if applicable (R65.2-).
Example 1: A woman presents to the emergency room with fever, chills, and abdominal pain after a recent miscarriage at home. Blood tests reveal an infection, and she is diagnosed with sepsis following a complete spontaneous abortion., A patient is admitted to the hospital for a spontaneous abortion.A few days later, she develops signs and symptoms consistent with sepsis. Cultures confirm a bacterial infection., A woman experiences a miscarriage and subsequently develops severe sepsis requiring intensive care and treatment for multi-organ dysfunction.
Documentation should clearly establish the occurrence of a complete or unspecified spontaneous abortion and subsequent development of sepsis. Supporting documentation includes clinical findings (e.g., fever, hypotension, tachycardia, elevated white blood cell count), laboratory results (positive blood cultures), and imaging studies as needed. Documentation of specific infectious organisms is recommended.
** Excludes1: septic or septicopyemic embolism following complete or unspecified spontaneous abortion (O03.7)
- Payment Status: Active
- Specialties:Obstetrics and Gynecology, Emergency Medicine, Critical Care Medicine, Family Medicine
- Place of Service:Inpatient Hospital, Emergency Room - Hospital, Office