Valid for Submission
O03.5 is a billable diagnosis code used to specify a medical diagnosis of genital tract and pelvic infection following complete or unspecified spontaneous abortion. The code O03.5 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.
The ICD-10-CM code O03.5 might also be used to specify conditions or terms like complete inevitable miscarriage complicated by genital tract and pelvic infection, complete miscarriage, complete miscarriage with genital tract or pelvic infection, female genital tract infection due to complete miscarriage, inevitable miscarriage complete , miscarriage complicated by genital-pelvic infection, etc.
The code O03.5 is applicable to female patients aged 12 through 55 years inclusive. It is clinically and virtually impossible to use this code on a non-female patient outside the stated age range.
Unspecified diagnosis codes like O03.5 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
Tabular List of Diseases and Injuries
The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code O03.5:
Inclusion TermsInclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- Endometritis following complete or unspecified spontaneous abortion
- Oophoritis following complete or unspecified spontaneous abortion
- Parametritis following complete or unspecified spontaneous abortion
- Pelvic peritonitis following complete or unspecified spontaneous abortion
- Salpingitis following complete or unspecified spontaneous abortion
- Salpingo-oophoritis following complete or unspecified spontaneous abortion
Type 1 ExcludesType 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
Index to Diseases and Injuries
The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code O03.5 are found in the index:
- - Abortion (complete) (spontaneous) - O03.9
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Complete inevitable miscarriage complicated by genital tract and pelvic infection
- Complete miscarriage
- Complete miscarriage with genital tract or pelvic infection
- Female genital tract infection due to complete miscarriage
- Inevitable miscarriage complete
- Miscarriage complicated by genital-pelvic infection
- Miscarriage with endometritis
- Miscarriage with parametritis
- Miscarriage with pelvic peritonitis
- Miscarriage with salpingitis
- Miscarriage with salpingo-oophoritis
- Postabortal pelvic inflammatory disease
Convert O03.5 to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code O03.5 its ICD-9 equivalent. The approximate mapping means there is not an exact match between the ICD-10 code and the ICD-9 code and the mapped code is not a precise representation of the original code.
Information for Patients
Also called: Spontaneous abortion
A miscarriage is an unexpected loss of pregnancy before the 20th week of pregnancy. Most miscarriages happen very early in the pregnancy, often before a woman even knows she is pregnant.
Factors that may contribute to miscarriage include
- A genetic problem with the fetus
- Problems with the uterus or cervix
- Chronic diseases, such as polycystic ovary syndrome
Signs of a miscarriage include vaginal spotting, abdominal pain or cramping, and fluid or tissue passing from the vagina. Bleeding can be a symptom of miscarriage, but many women also have it in early pregnancy and don't miscarry. To be sure, contact your health care provider right away if you have bleeding.
Women who miscarry early in their pregnancy usually do not need any treatment. In some cases, there is tissue left in the uterus. Doctors use a procedure called a dilatation and curettage (D&C) or medicines to remove the tissue.
Counseling may help you cope with your grief. Later, if you do decide to try again, work closely with your health care provider to lower the risks. Many women who have a miscarriage go on to have healthy babies.
NIH: National Institute of Child Health and Human Development
- D and C (Medical Encyclopedia)
- HCG blood test - quantitative (Medical Encyclopedia)
- Miscarriage (Medical Encyclopedia)
- Miscarriage - threatened (Medical Encyclopedia)
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