ICD-10 Diagnosis Code O03.81

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)

Shock happens when not enough blood and oxygen can get to your organs and tissues. It causes very low blood pressure and may be life threatening. It often happens along with a serious injury.

There are several kinds of shock. Hypovolemic shock happens when you lose a lot of blood or fluids. Causes include internal or external bleeding, dehydration, burns, and severe vomiting and/or diarrhea. Septic shock is caused by infections in the bloodstream. A severe allergic reaction can cause anaphylactic shock. An insect bite or sting might cause it. Cardiogenic shock happens when the heart cannot pump blood effectively. This may happen after a heart attack. Neurogenic shock is caused by damage to the nervous system.

Symptoms of shock include

• Confusion or lack of alertness
• Loss of consciousness
• Sudden and ongoing rapid heartbeat
• Sweating
• Pale skin
• A weak pulse
• Rapid breathing
• Decreased or no urine output
• Cool hands and feet

Shock is a life-threatening medical emergency and it is important to get help right away. Treatment of shock depends on the cause.

NIH: National Heart, Lung, and Blood Institute

• Anaphylaxis (Medical Encyclopedia)
• Cardiogenic shock (Medical Encyclopedia)
• Hypovolemic shock (Medical Encyclopedia)
• Septic shock (Medical Encyclopedia)
• Shock (Medical Encyclopedia)

General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

• Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
• No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
• Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.

Index of Diseases and Injuries Definitions

• And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
• Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
• Code first - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
• Type 1 Excludes Notes - 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.
• Type 2 Excludes Notes - A type 2 Excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
• Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
• Inclusion terms - List of terms is included under some codes. 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.
• NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
• NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
• See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
• See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
• 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
• With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.

Present on Admission
The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement.