Is O86.0 a billable ICD-10-CM code?

No. O86.0 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does O86.0 sit in the tabular list?

Pregnancy, childbirth and the puerperium (O00-O9A), in the block Complications predominantly related to the puerperium (O85-O92).

What cannot be coded together with O86.0?

O86.0 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter.

O86.0

O86.0 — Infection of obstetric surgical wound

Non-billable headerICD-10-CM

O86.0 is a non-billable header ICD-10-CM code for infection of obstetric surgical wound. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 — never code together

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

complications of procedures, not elsewhere classified (T81.4-)
postprocedural fever NOS (R50.82)
postprocedural retroperitoneal abscess (K68.11)

Inclusion terms

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

Infected cesarean delivery wound following delivery
Infected perineal repair following delivery

Excludes2 inherited from the categories above O86.0

Also inherited, and the opposite of Excludes1: these conditions are not part of O86.0, but a patient can have both, so you may code both.

Written on O86 — Other puerperal infections

infection during labor (O75.3)
obstetrical tetanus (A34)

Other codes that can never be billed with O86.0

These codes carry an Excludes1 note pointing at O86.0. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading O86.0 alone.

N71Inflammatory disease of uterus, except cervix

Risk adjustment

O86.0 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 history

O86.0 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead O86.0

6 child codes. Green means billable.

Related codes at this level

Codes that share O86. If O86.0 is not quite right, the correct code is usually one of these.

Questions about O86.0

Is O86.0 a billable ICD-10-CM code?: No. O86.0 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does O86.0 sit in the tabular list?: Pregnancy, childbirth and the puerperium (O00-O9A), in the block Complications predominantly related to the puerperium (O85-O92).
What cannot be coded together with O86.0?: O86.0 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter.