2026 ICD-10-CM Diagnosis Code O86.04Sepsis following an obstetrical procedure

ICD-10-CM Codes›O00-O9A›O85-O92›O86

ICD-10-CM O86.04
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

O86.04 is a billable ICD-10-CM diagnosis code for sepsis following an obstetrical procedure. 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 Complications specified during childbirth and Septicemia.

Code Identity

ICD-10-CM Code
O86.04
Billable Status
Yes — Valid for Submission
Code Describes
Sepsis following an obstetrical procedure
Short Description
Sepsis following an obstetrical procedure
Same as the full description in the CMS dataset.
Parent Code
O86.0
Infection of obstetric surgical wound

Code Classification

ChapterO00-O9APregnancy, childbirth and the puerperium
SectionO85-O92Complications predominantly related to the puerperium
CategoryO86Other puerperal infections
This CodeO86.04Sepsis following an obstetrical procedure

Code EditsBilling

Medicare Code Editor checks that affect claim validity for O86.04.

Maternity diagnoses
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).

Tabular List NotesGuidance

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

Use Additional Code

  • code to identify the sepsis

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

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

    • Sepsis(generalized) (unspecified organism)
      • following
        • obstetrical procedure

Clinical ClassificationClinical

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

CCSR PRG023
Complications specified during childbirth
Default principal diagnosis: inpatient Yes · outpatient Yes
CCSR INF002
Septicemia
Default principal diagnosis: inpatient No · outpatient No

Patient EducationClinical

After Surgery

After any operation, you'll have some side effects. There is usually some pain with surgery. There may also be swelling and soreness around the area that the surgeon cut. Your surgeon can tell you which side effects to expect.

Read the full article at MedlinePlus

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

Code History & ChangesHistory

Replacement O86.04 replaces the following previously assigned code(s):

  • O86.0 - Infection of obstetric surgical wound
FY 2019AddedAdded to the ICD-10-CM code setEffective October 1, 2018.
FY 2020–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About O86.04Overview

Is O86.04 (Infection of obstetric surgical wound) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report sepsis following an obstetrical procedure on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Who can O86.04 be reported for?

The Medicare Code Editor checks sepsis following an obstetrical procedure against patient demographics: this code is intended for maternity cases (age 9 through 64). Claims outside these limits are flagged as inconsistent.

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.