O86.04

O86.04: Sepsis following an obstetrical procedure

Billable / specific codeICD-10-CM

O86.04 is a billable, specific ICD-10-CM code for sepsis following an obstetrical procedure. It is valid for submission on a claim.

Check O86.04 with the rest of the claim: free scrubber

Use additional code

Add a secondary code to capture the detail described below.

code to identify the sepsis

Excludes1 inherited from the categories above O86.04

A category’s note binds every code beneath it.

Written on O86.0: Infection of obstetric surgical wound

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

Excludes2 inherited from the categories above O86.04

Not part of this code, but both may be coded when both are present.

Written on O86: Other puerperal infections

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

Other codes that can never be billed with O86.04

Their own Excludes1 notes name this code, so the conflict is not listed above.

N71Inflammatory disease of uterus, except cervix

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

O86.04 is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A56421Billing and Coding: CT of the Abdomen and Pelvis

Alphabetic index entries that lead here

Sepsis›following›obstetrical procedure

Code history

Unchanged in every release from FY2024 to FY2027.