2027 ICD-10-CM Diagnosis Code O03.85Other venous complications following complete or unspecified spontaneous abortion
ICD-10-CM Codes›O00-O9A›O00-O08›O03
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Not Chronic
O03.85 is a billable ICD-10-CM diagnosis code for other venous complications following complete or unspecified spontaneous abortion. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 770, 779. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 311 closely related codes. The code is restricted by the Medicare Code Editor to maternity cases (age 9 through 64). Coders also document this condition as disorder of vein following miscarriage. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Spontaneous abortion and complications of spontaneous abortion.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for O03.85.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Disorder of vein following miscarriage
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to O03.85: its own notes plus those printed at O03, block O00-O08, and Chapter 15. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
- supervision of normal pregnancy (Z34.-)
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code, if applicable, from category Z3A, Weeks of gestation, to identify the specific week of the pregnancy, if known.
Notes
General instructions on how these codes are used.
- Incomplete abortion includes retained products of conception following spontaneous abortion
- CODES FROM THIS CHAPTER ARE FOR USE ONLY ON MATERNAL RECORDS, NEVER ON NEWBORN RECORDS
- Codes from this chapter are for use for conditions related to or aggravated by the pregnancy, childbirth, or by the puerperium (maternal causes or obstetric causes)
- Trimesters are counted from the first day of the last menstrual period. They are defined as follows:
- 1st trimester- less than 14 weeks 0 days
- 2nd trimester- 14 weeks 0 days to less than 28 weeks 0 days
- 3rd trimester- 28 weeks 0 days until delivery
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name O03.85, its category, or a range that includes it.
Excludes1 12
These codes carry an Excludes1 note naming O03.85: they are not reported together with it, unless the two conditions are unrelated.
- Z33.2 Encounter for elective termination of pregnancyspontaneous abortion (O03) names O03, which includes this code
- G08 Intracranial and intraspinal phlebitis and thrombophlebitis
- K65 Peritonitis
- Block N70-N77 Inflammatory diseases of female pelvic organs
- R34 Anuria and oliguria
- R55 Syncope and collapse
- R57 Shock, not elsewhere classified
- T79.0 Air embolism (traumatic)
- T79.1 Fat embolism (traumatic)
- T79.4 Traumatic shock
- T81.1 Postprocedural shock
- T81.7 Vascular complications following a procedure, not elsewhere classified
Excludes2 6
These codes carry an Excludes2 note naming O03.85: its condition is not part of those codes, and both may be reported when the patient has both.
- D65 Disseminated intravascular coagulation [defibrination syndrome]
- D68 Other coagulation defects
- I26 Pulmonary embolism
- K72 Hepatic failure, not elsewhere classified
- Block N17-N19 Acute kidney failure and chronic kidney disease
- Block N30-N39 Other diseases of the urinary system
Code First 6
These codes say to code first a condition named in the note, and O03.85 is one of the conditions named.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Abortion, Spontaneous
expulsion of the product of fertilization before completing the term of gestation and without deliberate interference.
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 O03.85 to ICD-9-CMHistory
Code HistoryHistory
Questions About O03.85Overview
Is O03.85 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report other venous complications following complete or unspecified spontaneous abortion on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does O03.85 group to?
When other venous complications following complete or unspecified spontaneous abortion is the principal diagnosis on an inpatient stay, it groups to MS-DRG 779, 770, with relative weights from 1.0198 to 1.0987 depending on complications. Higher weights mean higher Medicare reimbursement.
Is O03.85 a CC or MCC?
CMS lists O03.85 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 311 closely related codes in its exclusion list.
Who can O03.85 be reported for?
The Medicare Code Editor checks other venous complications 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.
Can O03.85 be reported with a code from O31.1?
Not as a rule. The Excludes1 note at block O00-O08, which applies to O03.85, lists "continuing pregnancy in multiple gestation after abortion of one fetus or more (O31.1-, O31.3-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
