2027 ICD-10-CM Diagnosis Code O85Puerperal sepsis
ICD-10-CM Codes›O00-O9A›O85-O92›O85
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Not Chronic
O85 is a billable ICD-10-CM diagnosis code for puerperal sepsis. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 769, 776. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 225 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 puerperal peritonitis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Complications specified during the puerperium and Septicemia.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for O85.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Puerperal peritonitis
- Puerperal sepsis
- Sepsis following obstructed labor
- Sequelae of reproductive disorders
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to O85: its own notes plus those printed at block O85-O92 and Chapter 15. A note printed at a category, block or chapter applies to every code under it.
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Postpartum sepsis
- Puerperal peritonitis
- Puerperal pyemia
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.
- 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 O85, its category, or a range that includes it.
Excludes1 5
These codes carry an Excludes1 note naming O85: they are not reported together with it, unless the two conditions are unrelated.
- A40 Streptococcal sepsispuerperal sepsis (O85)
- A41 Other sepsispuerperal sepsis (O85)
- K65 Peritonitispuerperal peritonitis (O85)
- Block N70-N77 Inflammatory diseases of female pelvic organspregnancy, childbirth and the puerperium (O23.-, O75.3, O85, O86.-)
- N71 Inflammatory disease of uterus, except cervixinfection of uterus following delivery (O85, O86.-)
Excludes2 2
These codes carry an Excludes2 note naming O85: its condition is not part of those codes, and both may be reported when the patient has both.
Code First 1
These codes say to code first a condition named in the note, and O85 is one of the conditions named.
- R65.2 Severe sepsispuerperal sepsis (O85)
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Abscess (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic) L02.91
Pelviperitonitis See Also: Peritonitis, pelvic;
puerperal O85
Peritonitis (adhesive) (bacterial) (fibrinous) (hemorrhagic) (idiopathic) (localized) (perforative) (primary) (with adhesions) (with effusion) K65.9
Puerperal, puerperium (complicated by, complications)
peritoneum O85
fever (of unknown origin) O86.4
septic O85
generalized O85
peritoneum O85
metroperitonitis O85
parametritis O85
pelviperitonitis O85
pyemia O85
pyohemia O85
sepsis (pelvic) O85
Pyemia, pyemic (fever) (infection) (purulent) See Also: Sepsis;
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Infections and Pregnancy
During pregnancy, some common infections such as the common cold or a skin infection do not usually cause serious problems. Some infections, such as the flu, can be more severe when you're pregnant. But other infections can be harmful to you, your fetus, or both.
The full article covers:
- How can infections affect your pregnancy?
- What infections can be harmful during pregnancy?
- What are the symptoms of an infection during pregnancy?
- What are the treatments for infections during pregnancy?
- Can infections during pregnancy be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert O85 to ICD-9-CMHistory
Code HistoryHistory
Questions About O85Overview
What is the ICD-10 code for puerperal sepsis?
The ICD-10-CM code for puerperal sepsis is O85. It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is O85 (Puerperal sepsis) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report puerperal sepsis on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does O85 group to?
When puerperal sepsis is the principal diagnosis on an inpatient stay, it groups to MS-DRG 769, 776, with relative weights from 0.6718 to 1.6666 depending on complications. Higher weights mean higher Medicare reimbursement.
Is O85 a CC or MCC?
CMS lists O85 as an MCC (major complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 225 closely related codes in its exclusion list.
Who can O85 be reported for?
The Medicare Code Editor checks puerperal sepsis against patient demographics: this code is intended for maternity cases (age 9 through 64). Claims outside these limits are flagged as inconsistent.
