2026 ICD-10-CM Diagnosis Code O03.5Genital tract and pelvic infection following complete or unspecified spontaneous abortion

ICD-10-CM CodesO00-O9AO00-O08O03

ICD-10-CM O03.5
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

O03.5 is a billable ICD-10-CM diagnosis code for genital tract and pelvic infection following complete or unspecified spontaneous abortion. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). The code is restricted by the Medicare Code Editor to maternity cases (age 9 through 64). In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Spontaneous abortion and complications of spontaneous abortion.

Code Identity

ICD-10-CM Code
O03.5
Billable Status
Yes — Valid for Submission
Code Describes
Genital tract and pelvic infection following complete or unspecified spontaneous abortion
Short Description
Genitl trct and pelvic infct fol complete or unsp spon abort
Parent Code
Spontaneous abortion

Code Classification

ChapterO00-O9APregnancy, childbirth and the puerperium
SectionO00-O08Pregnancy with abortive outcome
CategoryO03Spontaneous abortion
This CodeO03.5Genital tract and pelvic infection following complete or unspecified spontaneous abortion

Code EditsBilling

Medicare Code Editor checks that affect claim validity for O03.5.

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).

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this 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
  • Pelvic peritonitis
  • Postabortal pelvic inflammatory disease
  • Tubo-ovarian inflammatory disease

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Inclusion Terms

  • 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

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

Index to Diseases and InjuriesGuidance

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Abortion(complete) (spontaneous)
      • complicated (by) (following)
        • endometritis
    • Abortion(complete) (spontaneous)
      • complicated (by) (following)
        • genital tract and pelvic infection
    • Abortion(complete) (spontaneous)
      • complicated (by) (following)
        • infection
          • genital tract or pelvic
    • Abortion(complete) (spontaneous)
      • complicated (by) (following)
        • oophoritis
    • Abortion(complete) (spontaneous)
      • complicated (by) (following)
        • parametritis
    • Abortion(complete) (spontaneous)
      • complicated (by) (following)
        • pelvic peritonitis
    • Abortion(complete) (spontaneous)
      • complicated (by) (following)
        • salpingitis or salpingo-oophoritis

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR PRG003
Spontaneous abortion and complications of spontaneous abortion
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • 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.
  • Pelvic Peritonitis

    inflammation of the peritoneum surrounding the pelvic organs.

Patient EducationClinical

Miscarriage

A miscarriage is an unexpected loss of pregnancy before the 20th week. Most miscarriages happen very early in the pregnancy, often before a woman even knows she is pregnant.

The full article covers:

  • What is a miscarriage?
  • What causes a miscarriage?
  • What are the signs of a miscarriage?
  • How is a miscarriage diagnosed?
  • What is the treatment for a miscarriage?
  • Can a miscarriage be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert O03.5 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
634.00 Spon abor w pel inf-unsp
Approximate The match is approximate rather than exact.
ICD-9-CM
634.02 Spon abor w pel inf-comp
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About O03.5Overview

Is O03.5 (Spontaneous abortion) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report genital tract and pelvic infection following complete or unspecified spontaneous abortion on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Who can O03.5 be reported for?

The Medicare Code Editor checks genital tract and pelvic infection following complete or unspecified spontaneous abortion against patient demographics: this code is intended for maternity cases (age 9 through 64). Claims outside these limits are flagged as inconsistent.

What is the ICD-9 equivalent of O03.5?

Under the General Equivalence Mappings, genital tract and pelvic infection following complete or unspecified spontaneous abortion converts to ICD-9-CM 634.00 (spon abor w pel inf-unsp) and 634.02 (spon abor w pel inf-comp). The mapping is approximate, so confirm the match fits the documentation.

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.