2024 ICD-10-CM Diagnosis Code O03.5

Genital tract and pelvic infection following complete or unspecified spontaneous abortion

ICD-10-CM Code:
O03.5
ICD-10 Code for:
Genitl trct and pelvic infct fol complete or unsp spon abort
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Not chronic
Code Navigator:

Code Classification

  • Pregnancy, childbirth and the puerperium
    (O00-O9A)
    • Pregnancy with abortive outcome
      (O00-O08)
      • Spontaneous abortion
        (O03)

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 is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

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.

Approximate Synonyms

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
  • 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
  • Parametritis
  • Postabortal pelvic inflammatory disease
  • Tubo-ovarian inflammatory disease

Clinical Classification

Clinical Information

  • Parametritis

    inflammation of the parametrium, the connective tissue of the pelvic floor, extending from the subserous coat of the uterus laterally between the layers of the broad ligament.
  • Broad Ligament

    a broad fold of peritoneum that extends from the side of the uterus to the wall of the pelvis.

Tabular List of Diseases and Injuries

The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.


Inclusion Terms

Inclusion 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 Excludes

Type 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.
  • sepsis following complete or unspecified spontaneous abortion O03.87
  • urinary tract infection following complete or unspecified spontaneous abortion O03.88

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

  • Maternity diagnoses - The Medicare Code Editor detects inconsistencies in maternity cases by checking a patient's age and any diagnosis on the patient's record. The maternity code edits apply to patients age ange is 9–64 years inclusive (e.g., diabetes in pregnancy, antepartum pulmonary complication).
  • Diagnoses for females only - The Medicare Code Editor detects inconsistencies between a patient’s sex and any diagnosis on the patient’s record, these edits apply to FEMALES only .

Convert O03.5 to ICD-9-CM

  • ICD-9-CM Code: 634.00 - Spon abor w pel inf-unsp
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.
  • ICD-9-CM Code: 634.02 - Spon abor w pel inf-comp
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education


Miscarriage

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


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.