Puerperal sepsis
In Complications predominantly related to the puerperium (O85-O92), chapter 15: Pregnancy, Childbirth and the Puerperium
- O85 is billable and valid on claims for FY 2027. If the record has more detail, check the other codes under O85-O92 below.
- As a secondary diagnosis it is an MCC (major complication), which can raise the MS-DRG payment. It doesn't count when the principal diagnosis is one of 225 closely related codes.
- Doesn't count toward a Medicare Advantage risk score (no HCC in V28).
- AHRQ's Chronic Condition Indicator classes it as not chronic (an acute or short-term condition).
- Expected only on maternity records. (Maternity list)
Also indexed as: Abscess, peritoneum, peritoneal, puerperal, postpartum, childbirth; Infection, major, puerperal, postpartum, childbirth; Infection, puerperal, major or generalized; Pelviperitonitis, puerperal; Peritonitis, puerperal, postpartum, childbirth; Puerperal, abscess, peritoneum; Puerperal, fever, septic; Puerperal, infection, generalized; Puerperal, infection, peritoneum; Puerperal, metroperitonitis; Puerperal, parametritis; Puerperal, pelviperitonitis; Puerperal, peritoneal infection; Puerperal, peritonitis; Puerperal, pyemia; Puerperal, pyohemia; Puerperal, salpingoperitonitis; Puerperal, sepsis; Pyemia, puerperal, postpartum, childbirth; Sepsis, pelvic, puerperal, postpartum, childbirth; Sepsis, puerperal, postpartum, childbirth
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Instructional notes
Includes: conditions that are coded here
- Postpartum sepsis
- Puerperal peritonitis
- Puerperal pyemia
Excludes1: not coded here, use a different code
Excludes2: not included here, code separately if applicable
Also applies, from Complications predominantly related to the puerperium (O85-O92)
These notes sit on O85-O92 and apply to every code under it, including O85.
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
- Section I.C.15.k Puerperal sepsis (page 67), covers O85
Assign O85 with a secondary code for the causal organism, such as B95-B96, plus R65.2- and organ dysfunction codes if applicable. Do not use A40 or A41 for puerperal sepsis, or O85 for sepsis after an obstetric procedure.
Other Chapter 15 topics:
- General Rules for Obstetric Cases (page 63)
- Selection of OB Principal or First-listed Diagnosis (page 64)
- Pre-existing conditions versus conditions due to the pregnancy (page 65)
- Pre-existing hypertension in pregnancy (page 66)
- Fetal Conditions Affecting the Management of the Mother (page 66)
- HIV Infection in Pregnancy, Childbirth and the Puerperium (page 66)
- Diabetes mellitus in pregnancy (page 66)
- Long term use of insulin and oral hypoglycemics (page 67)
Other codes under O85-O92
Complications predominantly related to the puerperium (O85-O92)
- O85Puerperal sepsis(this code)
- O86Other puerperal infections
- O87Venous complications and hemorrhoids in the puerperium
- O88Obstetric embolism
- O89Complications of anesthesia during the puerperium
- O90Complications of the puerperium, not elsewhere classified
- O91Infections of breast associated with pregnancy, the puerperium and lactation
- O92Other disorders of breast and disorders of lactation associated with pregnancy and the puerperium
O85 MS-DRGs
As the principal diagnosis, O85 groups to MS-DRG 769 or 776 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
Related conditions
Grouped by AHRQ's Clinical Classifications Software Refined (CCSR), which sorts every diagnosis code into clinically meaningful categories.
O85 is in Complications specified during the puerperium (PRG027, its default category), with 132 codes. Others in it:
- F53.0 Postpartum depression
- F53.1 Puerperal psychosis
- M83.0 Puerperal osteomalacia
- O10.03 Pre-existing essential hypertension complicating the puerperium
- O10.13 Pre-existing hypertensive heart disease complicating the puerperium
- O10.23 Pre-existing hypertensive chronic kidney disease complicating the puerperium
- O10.33 Pre-existing hypertensive heart and chronic kidney disease complicating the puerperium
- O10.43 Pre-existing secondary hypertension complicating the puerperium
Medicare coverage articles listing O85
These 2 Medicare billing and coding articles list O85 as a diagnosis that supports medical necessity for the services they cover. From the CMS Medicare Coverage Database; check your own contractor's article before billing.
Other codes that refer to O85
Notes on these codes point to O85.
- A40 Excludes1: puerperal sepsis (O85)
- A41 Excludes1: puerperal sepsis (O85)
- K65 Excludes1: puerperal peritonitis (O85)
- N70-N77 Excludes1: pregnancy, childbirth and the puerperium (O23.-, O75.3, O85, O86.-)
- N71 Excludes1: infection of uterus following delivery (O85, O86.-)
- O75 Excludes2: puerperal (postpartum) sepsis (O85)
- O98 Excludes2: puerperal sepsis (O85)
- R65.2 Code First: puerperal sepsis (O85)
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Infections and Pregnancy
During pregnancy, some common infections such as the common cold or a skin infection do not usually cause serious problems. Some infections, such as the flu, can be more severe when you're pregnant. But other infections can be harmful to you, your fetus, or both.
Read more about infections and pregnancy on MedlinePlusPostpartum Care
Taking home a new baby is one of the happiest times in a woman's life. But it also presents both physical and emotional challenges. : In addition to physical changes, you may feel sad or have the "baby blues." If you are extremely sad or are unable to care for yourself or your baby, you might have a serious condition called postpartum depression.
Read more about postpartum care on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.
ICD-9-CM equivalent
Legacy crosswalk from the CMS General Equivalence Mappings (last updated 2018).
- 670.22 Puerperal sepsis, delivered, with mention of postpartum complication (approximate)
- 670.24 Puerperal sepsis, postpartum condition or complication (approximate)