2025 ICD-10-CM code O26.2
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Maternal - Other maternal disorders predominantly related to pregnancy Chapter 15: Pregnancy, childbirth and the puerperium (O00-O9A) Feed
Pregnancy care for a patient with recurrent pregnancy loss.
Medical necessity is established by the presence of recurrent pregnancy loss, defined as two or more spontaneous abortions.The ongoing monitoring and care provided aim to prevent further losses and improve pregnancy outcomes.
The clinical responsibility lies with the obstetrician or maternal-fetal medicine specialist.This may include regular prenatal visits, ultrasounds, blood tests, and management of any complications.
- Chapter 15: Pregnancy, childbirth and the puerperium (O00-O9A)
- O26 - Maternal care for other conditions predominantly related to pregnancy
In simple words: This code is used when a pregnant woman has had multiple miscarriages and is receiving medical care to help her have a successful pregnancy.The doctor will track the pregnancy closely to try to prevent another loss.
This code is used for maternal care provided to a patient experiencing recurrent pregnancy loss.It encompasses the management and monitoring of the pregnancy to mitigate the risk of further loss.The trimester of the pregnancy should be specified using additional codes (e.g., O26.21, O26.22, O26.23 for first, second, and third trimesters respectively).This code is exclusively for use in maternal records and should not be applied to newborn records.
Example 1: A 35-year-old woman with a history of three prior miscarriages presents for her first prenatal appointment at 8 weeks gestation.She is monitored closely with frequent ultrasounds and blood work.Code O26.21 is used., A 30-year-old woman at 20 weeks gestation with two prior miscarriages presents for a routine prenatal checkup and an ultrasound shows a normal fetal heartbeat. Code O26.22 is appropriate., A 28-year-old woman at 36 weeks gestation with a history of recurrent pregnancy loss requires careful monitoring for potential complications such as preterm labor or preeclampsia. Code O26.23 is used.
Detailed history of prior pregnancies and their outcomes (dates, gestational age at loss, cause of loss if known). Documentation of current pregnancy, including gestational age, fetal well-being assessments (ultrasounds, fetal heart rate monitoring), and any treatments or interventions (e.g., medications, bed rest).
** This code should only be used for maternal care related to recurrent pregnancy loss.Conditions that may be associated with recurrent pregnancy loss but are coded separately include chromosomal abnormalities, uterine abnormalities, endocrine disorders, and autoimmune disorders.
- Payment Status: Active
- Specialties:Obstetrics, Maternal-Fetal Medicine
- Place of Service:Office, Hospital (inpatient or outpatient), Ambulatory Surgical Center