Is O86.09 a billable ICD-10-CM code?

Yes. O86.09 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does O86.09 sit in the tabular list?

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

O86.09

O86.09 — Infection of obstetric surgical wound, other surgical site

Billable / specific codeICD-10-CM

O86.09 is a billable, specific ICD-10-CM code for infection of obstetric surgical wound, other surgical site. It is valid for submission on a claim.

Risk adjustment

O86.09 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

O86.09 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 O86.09 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 O86.09.

Infection, infected, infective›episiotomy(puerperal)
Infection, infected, infective›perineal repair(puerperal)
Complication›perineal repair NEC›infection(following delivery)
Infection, infected, infective›obstetrical surgical wound›surgical site specified NEC
Puerperal, puerperium›infection›genital tract NEC›obstetric surgical wound

Related codes at this level

Codes that share O86.0. If O86.09 is not quite right, the correct code is usually one of these.

Questions about O86.09

Is O86.09 a billable ICD-10-CM code?: Yes. O86.09 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does O86.09 sit in the tabular list?: Pregnancy, childbirth and the puerperium (O00-O9A), in the block Complications predominantly related to the puerperium (O85-O92).