Miscarriage and Early Pregnancy Loss ICD-10-CM codes

In ICD-10-CM a spontaneous abortion is a pregnancy loss before 20 completed weeks. O03.9 (complete or unspecified spontaneous abortion without complication) is the default. O03.4 is an incomplete spontaneous abortion without complication. Complications are built into the fourth and fifth characters: O03.0 to O03.3- follow an incomplete abortion and O03.5 to O03.8- follow a complete or unspecified one, covering infection, delayed or excessive hemorrhage, embolism, shock, renal failure, sepsis, and other complications. Fetal death at 20 weeks or later is coded to O36.4XX0, not O03.

Missed abortion (fetal demise before 20 weeks with retained products and no expulsion) is O02.1, and a blighted ovum or nonhydatidiform mole is O02.0. Threatened abortion, meaning bleeding with a continuing viable pregnancy, is O20.0; other early hemorrhage is O20.8 or O20.9. Per the official guidelines, a subsequent encounter for retained products of conception after a spontaneous abortion is coded to O03.4 (or with the applicable O03 complication code) even if the earlier discharge diagnosis was a complete abortion.

Do not assign a Z3A weeks-of-gestation code with O00 to O08; the guidelines exclude pregnancies with abortive outcomes. Supervision of a later pregnancy in a patient with a history of pregnancy loss is O09.29- (for example O09.291 in the first trimester). Elective termination is O04 or Z33.2, not O03.