2026 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 2026 (October 1, 2025 through September 30, 2026) 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
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Postpartum sepsis
- Puerperal peritonitis
- Puerperal pyemia
Use Additional Code
Type 1 Excludes
- fever of unknown origin following delivery O86.4
- obstetric pyemic and septic embolism O88.3
- puerperal septic thrombophlebitis O86.81
Type 2 Excludes
- genital tract infection following delivery O86.1
- sepsis during labor O75.3
- urinary tract infection following delivery O86.2
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.
The “use additional code” indicates that a secondary code could be used to further specify the patient’s condition. This note is not mandatory and is only used if enough information is available to assign an additional code.
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.
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.
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
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, 2025 through September 30, 2026.
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 0.6547 to 1.6898 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 2026. 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.
What is the ICD-9 equivalent of O85?
Under the General Equivalence Mappings, puerperal sepsis converts to ICD-9-CM 670.22 (puerprl sepsis-del w p/p) and 670.24 (puerperl sepsis-postpart). 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.
