O03
O03 — Spontaneous abortion
Non-billable headerICD-10-CM
O03 is a non-billable header ICD-10-CM code for spontaneous abortion. It cannot be billed on its own: choose one of the more specific child codes below.
Includes
Conditions this code covers.
- miscarriage
Notes
Additional guidance from the ICD-10-CM tabular list.
- Incomplete abortion includes retained products of conception following spontaneous abortion
Other codes that can never be billed with O03
These codes carry an Excludes1 note pointing at O03. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading O03 alone.
- O03.0Genital tract and pelvic infection following incomplete spontaneous abortion
- O03.31Shock following incomplete spontaneous abortion
- O03.37Sepsis following incomplete spontaneous abortion
- O03.5Genital tract and pelvic infection following complete or unspecified spontaneous abortion
- O03.81Shock following complete or unspecified spontaneous abortion
- O03.87Sepsis following complete or unspecified spontaneous abortion
- O07Failed attempted termination of pregnancy
- O08.1Delayed or excessive hemorrhage following ectopic and molar pregnancy
Risk adjustment
O03 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code to one of these instead O03
10 child codes. Green means billable.
- O03.0Genital tract and pelvic infection following incomplete spontaneous abortion
- O03.1Delayed or excessive hemorrhage following incomplete spontaneous abortion
- O03.2Embolism following incomplete spontaneous abortion
- O03.3Other and unspecified complications following incomplete spontaneous abortion
- O03.4Incomplete spontaneous abortion without complication
- O03.5Genital tract and pelvic infection following complete or unspecified spontaneous abortion
- O03.6Delayed or excessive hemorrhage following complete or unspecified spontaneous abortion
- O03.7Embolism following complete or unspecified spontaneous abortion
- O03.8Other and unspecified complications following complete or unspecified spontaneous abortion
- O03.9Complete or unspecified spontaneous abortion without complication
Questions about O03
- Is O03 a billable ICD-10-CM code?
- No. O03 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does O03 sit in the tabular list?
- Pregnancy, childbirth and the puerperium (O00-O9A), in the block Pregnancy with abortive outcome (O00-O08).