2025 ICD-10-CM code O85
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Obstetrics - Complications predominantly related to the puerperium Pregnancy, childbirth and the puerperium Feed
Puerperal sepsis is a postpartum infection.
Medical necessity is established by the presence of clinical signs and symptoms consistent with puerperal sepsis, confirmed by laboratory findings and/or imaging studies. Treatment is medically necessary to prevent serious complications such as septic shock and organ failure.
Obstetricians and gynecologists are primarily responsible for managing puerperal sepsis.Other specialists might be involved depending on the severity and complications.
In simple words: Puerperal sepsis is a serious infection that can happen after childbirth. It's an infection of the reproductive organs, and it can be mild or very dangerous.Doctors might use other codes to describe exactly what kind of infection it is.
Puerperal sepsis, also known as postpartum sepsis or puerperal infection, is a serious infection affecting the female reproductive system following childbirth.It can range from mild to life-threatening, involving various sites such as the uterus (endometritis), fallopian tubes (salpingitis), or other pelvic organs.Additional codes (B95-B97) may be used to specify the infectious agent, and code R65.2- should be added if severe sepsis is present.Excludes1: fever of unknown origin following delivery (O86.4), obstetric pyemic and septic embolism (O88.3-), puerperal septic thrombophlebitis (O86.81). Excludes2: genital tract infection following delivery (O86.1-), sepsis during labor (O75.3), urinary tract infection following delivery (O86.2-).
Example 1: A 30-year-old woman develops a high fever, chills, and uterine tenderness three days after a vaginal delivery.Physical examination reveals purulent lochia. Cultures reveal Staphylococcus aureus.Code O85 is assigned, along with a code for Staphylococcus aureus infection (B95.6)., A 25-year-old woman presents with pelvic pain, fever, and tachycardia one week after a cesarean section.Ultrasound shows evidence of pelvic abscess.The patient is diagnosed with puerperal sepsis.Code O85 is assigned, along with additional codes specifying the location and severity of the infection, and the infectious agent if identified., A 35-year-old woman with a history of diabetes develops severe sepsis after a vaginal delivery.She experiences hypotension, acute respiratory distress syndrome (ARDS), and acute kidney injury (AKI).Code O85 is assigned, along with codes for severe sepsis (R65.21) and the specific organ dysfunctions (J96.90 for ARDS and N17.9 for AKI), along with appropriate codes for diabetes and the specific infectious organism if known.
Detailed history and physical examination, including vital signs, obstetric history, signs and symptoms (fever, chills, tachycardia, hypotension, uterine tenderness, purulent lochia), laboratory results (complete blood count, blood cultures, urine culture, imaging findings if applicable), treatment details (antibiotics, surgery if performed), and response to treatment.
** The information provided here is for educational purposes only. Always consult the most up-to-date coding manuals and guidelines for accurate medical billing.
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- Specialties:Obstetrics and Gynecology, Infectious Disease
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office