Is O02.1 a billable ICD-10-CM code?

Yes. O02.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does O02.1 sit in the tabular list?

Pregnancy, childbirth and the puerperium (O00-O9A), in the block Pregnancy with abortive outcome (O00-O08).

What cannot be coded together with O02.1?

O02.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

O02.1

O02.1 — Missed abortion

Billable / specific codeICD-10-CM

O02.1 is a billable, specific ICD-10-CM code for missed abortion. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

failed induced abortion (O07.-)
fetal death (intrauterine) (late) (O36.4)
missed abortion with blighted ovum (O02.0)
missed abortion with hydatidiform mole (O01.-)
missed abortion with nonhydatidiform (O02.0)
missed abortion with other abnormal products of conception (O02.8-)
missed delivery (O36.4)
stillbirth (P95)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Early fetal death, before completion of 20 weeks of gestation, with retention of dead fetus

Other codes that can never be billed with O02.1

These codes carry an Excludes1 note pointing at O02.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading O02.1 alone.

O36.4Maternal care for intrauterine death
O36.4XX0Maternal care for intrauterine death, not applicable or unspecified
O36.4XX1Maternal care for intrauterine death, fetus 1
O36.4XX2Maternal care for intrauterine death, fetus 2
O36.4XX3Maternal care for intrauterine death, fetus 3
O36.4XX4Maternal care for intrauterine death, fetus 4
O36.4XX5Maternal care for intrauterine death, fetus 5
O36.4XX9Maternal care for intrauterine death, other fetus

Risk adjustment

O02.1 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.

Medicare coverage

O02.1 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A57189Billing and Coding: Serum Magnesium

How O02.1 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to O02.1.

Abortion›missed
Missed›abortion
Dead›fetus, retained›early pregnancy
Retention›products of conception›early pregnancy(dead fetus)
Delivery›complicated›by›intrauterine fetal death, early
Pregnancy›complicated by›death of fetus›early pregnancy
Pregnancy›complicated by›intrauterine fetal death›early pregnancy
Pregnancy›complicated by›missed›abortion
Retention›dead›fetus›early fetal death
Retention›fetus›dead›early
Delivery›complicated›by›fetal›death, early
Pregnancy›complicated by›fetal›death›early pregnancy

Related codes at this level

Codes that share O02. If O02.1 is not quite right, the correct code is usually one of these.

Questions about O02.1

Is O02.1 a billable ICD-10-CM code?: Yes. O02.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does O02.1 sit in the tabular list?: Pregnancy, childbirth and the puerperium (O00-O9A), in the block Pregnancy with abortive outcome (O00-O08).
What cannot be coded together with O02.1?: O02.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.