O86.04 — Sepsis following an obstetrical procedure
O86.04 is a billable, specific ICD-10-CM code for sepsis following an obstetrical procedure. It is valid for submission on a claim.
Use additional code
Add a secondary code to capture the detail described below.
- code to identify the sepsis
Risk adjustment
O86.04 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
O86.04 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.
- A56421Billing and Coding: CT of the Abdomen and Pelvis
How O86.04 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 O86.04.
- Sepsis›following›obstetrical procedure
Related codes at this level
Codes that share O86.0. If O86.04 is not quite right, the correct code is usually one of these.
- O86.00Infection of obstetric surgical wound, unspecified
- O86.01Infection of obstetric surgical wound, superficial incisional site
- O86.02Infection of obstetric surgical wound, deep incisional site
- O86.03Infection of obstetric surgical wound, organ and space site
- O86.09Infection of obstetric surgical wound, other surgical site
Questions about O86.04
- Is O86.04 a billable ICD-10-CM code?
- Yes. O86.04 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does O86.04 sit in the tabular list?
- Pregnancy, childbirth and the puerperium (O00-O9A), in the block Complications predominantly related to the puerperium (O85-O92).