2019

  1. ICD-10-CM Codes
    2. ›
  2. O00-O9A Pregnancy, childbirth and the puerperium
    3. ›
  3. O85-O92 Complications predominantly related to the puerperium
    4. ›
  4. O85- Puerperal sepsis
    5. ›

2019 ICD-10-CM Diagnosis Code O85

Puerperal sepsis

    2016 2017 2018 2019 Billable/Specific Code Maternity Dx (12-55 years) Female Dx
  • O85 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • The 2019 edition of ICD-10-CM O85 became effective on October 1, 2018.
  • This is the American ICD-10-CM version of O85 - other international versions of ICD-10 O85 may differ.
ICD-10-CM Coding Rules
  • O85 is applicable to maternity patients aged 12 - 55 years inclusive.
  • O85 is applicable to female patients.
Applicable To
  • Postpartum sepsis
  • Puerperal peritonitis
  • Puerperal pyemia
Use Additional
Use Additional Help
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
  • code (B95-B97
    ICD-10-CM Range B95-B97

    Bacterial and viral infectious agents

    Note
    • These categories are provided for use as supplementary or additional codes to identify the infectious agent(s) in diseases classified elsewhere.
    • B95 Streptococcus, Staphylococcus, and Enter...
    • B96 Other bacterial agents as the cause of d...
    • B97 Viral agents as the cause of diseases cl...
    ), to identify infectious agent
Type 1 Excludes
Type 1 Excludes Help
A type 1 excludes note is a pure excludes. It means "not coded here". A type 1 excludes note indicates that the code excluded should never be used at the same time as O85. A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • fever of unknown origin following delivery (
    ICD-10-CM Diagnosis Code O86.4

    Pyrexia of unknown origin following delivery

      2016 2017 2018 2019 Billable/Specific Code Maternity Dx (12-55 years) Female Dx
    Applicable To
    • Puerperal infection NOS following delivery
    • Puerperal pyrexia NOS following delivery
    Type 2 Excludes
    • pyrexia during labor (O75.2)
    O86.4
    )
  • genital tract infection following delivery (
    ICD-10-CM Diagnosis Code O86.1

    Other infection of genital tract following delivery

      2016 2017 2018 2019 Non-Billable/Non-Specific Code
    O86.1-
    )
  • obstetric pyemic and septic embolism (
    ICD-10-CM Diagnosis Code O88.3

    Obstetric pyemic and septic embolism

      2016 2017 2018 2019 Non-Billable/Non-Specific Code
    O88.3-
    )
  • puerperal septic thrombophlebitis (
    ICD-10-CM Diagnosis Code O86.81

    Puerperal septic thrombophlebitis

      2016 2017 2018 2019 Billable/Specific Code Maternity Dx (12-55 years) Female Dx
    O86.81
    )
  • urinary tract infection following delivery (
    ICD-10-CM Diagnosis Code O86.2

    Urinary tract infection following delivery

      2016 2017 2018 2019 Non-Billable/Non-Specific Code
    O86.2-
    )
Type 2 Excludes
Type 2 Excludes Help
A type 2 excludes note represents "not included here". A type 2 excludes note indicates that the condition excluded is not part of the condition it is excluded from but a patient may have both conditions at the same time. When a type 2 excludes note appears under a code it is acceptable to use both the code (O85) and the excluded code together.
  • sepsis during labor (
    ICD-10-CM Diagnosis Code O75.3

    Other infection during labor

      2016 2017 2018 2019 Billable/Specific Code Maternity Dx (12-55 years) Female Dx
    Applicable To
    • Sepsis during labor
    Use Additional
    • code (B95-B97), to identify infectious agent
    O75.3
    )
The following code(s) above O85 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to O85:
  • O00-O9A
    2019 ICD-10-CM Range O00-O9A

    Pregnancy, childbirth and the puerperium

    Note
    • CODES FROM THIS CHAPTER ARE FOR USE ONLY ON MATERNAL RECORDS, NEVER ON NEWBORN RECORDS
    • Codes from this chapter are for use for conditions related to or aggravated by the pregnancy, childbirth, or by the puerperium (maternal causes or obstetric causes)
    • Trimesters are counted from the first day of the last menstrual period. They are defined as follows:
    • 1st trimester- less than 14 weeks 0 days
    • 2nd trimester- 14 weeks 0 days to less than 28 weeks 0 days
    • 3rd trimester- 28 weeks 0 days until delivery
    Type 1 Excludes
    • supervision of normal pregnancy (Z34.-)
    Type 2 Excludes
    • mental and behavioral disorders associated with the puerperium (F53.-)
    • obstetrical tetanus (A34)
    • postpartum necrosis of pituitary gland (E23.0)
    • puerperal osteomalacia (M83.0)
    Use Additional
    • code from category Z3A, Weeks of gestation, to identify the specific week of the pregnancy, if known.
    Pregnancy, childbirth and the puerperium
  • O85-O92
    2019 ICD-10-CM Range O85-O92

    Complications predominantly related to the puerperium

    Type 2 Excludes
    • mental and behavioral disorders associated with the puerperium (F53.-)
    • obstetrical tetanus (A34)
    • puerperal osteomalacia (M83.0)
    Complications predominantly related to the puerperium
Approximate Synonyms
  • Postpartum sepsis
  • Puerperal peritonitis
  • Puerperal peritonitis (inflammation of abdominal lining)
  • Puerperal sepsis, postpartum (after childbirth)
  • Sepsis during labor
  • Sepsis in childbirth
  • Sepsis in childbirth (whole body reaction to serious infection)
ICD-10-CM O85 is grouped within Diagnostic Related Group(s) (MS-DRG v36.0):
  • 769 Postpartum and post abortion diagnoses with o.r. Procedure
  • 776 Postpartum and post abortion diagnoses without o.r. Procedure

Convert O85 to ICD-9-CM

Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
Code annotations containing back-references to O85:
  • Code First: R65.2
    ICD-10-CM Diagnosis Code R65.2

    Severe sepsis

      2016 2017 2018 2019 Non-Billable/Non-Specific Code
    Applicable To
    • Infection with associated acute organ dysfunction
    • Sepsis with acute organ dysfunction
    • Sepsis with multiple organ dysfunction
    • Systemic inflammatory response syndrome due to infectious process with acute organ dysfunction
    Code First
    • underlying infection, such as:
    • infection following a procedure (T81.4-)
    • infections following infusion, transfusion and therapeutic injection (T80.2-)
    • puerperal sepsis (O85)
    • sepsis following complete or unspecified spontaneous abortion (O03.87)
    • sepsis following ectopic and molar pregnancy (O08.82)
    • sepsis following incomplete spontaneous abortion (O03.37)
    • sepsis following (induced) termination of pregnancy (O04.87)
    • sepsis NOS (A41.9)
    Use Additional
    • code to identify specific acute organ dysfunction, such as:
    • acute kidney failure (N17.-)
    • acute respiratory failure (J96.0-)
    • critical illness myopathy (G72.81)
    • critical illness polyneuropathy (G62.81)
    • disseminated intravascular coagulopathy [DIC] (D65)
    • encephalopathy (metabolic) (septic) (G93.41)
    • hepatic failure (K72.0-)
  • Type 1 Excludes: A40
    , A41
    , N71
    , K65
    ICD-10-CM Diagnosis Code A40

    Streptococcal sepsis

      2016 2017 2018 2019 Non-Billable/Non-Specific Code
    Code First
    • postprocedural streptococcal sepsis (T81.4-)
    • streptococcal sepsis during labor (O75.3)
    • streptococcal sepsis following abortion or ectopic or molar pregnancy (O03-O07, O08.0)
    • streptococcal sepsis following immunization (T88.0)
    • streptococcal sepsis following infusion, transfusion or therapeutic injection (T80.2-)
    Type 1 Excludes
    ICD-10-CM Diagnosis Code A41

    Other sepsis

      2016 2017 2018 2019 Non-Billable/Non-Specific Code
    Code First
    • postprocedural sepsis (T81.4-)
    • sepsis during labor (O75.3)
    • sepsis following abortion, ectopic or molar pregnancy (O03-O07, O08.0)
    • sepsis following immunization (T88.0)
    • sepsis following infusion, transfusion or therapeutic injection (T80.2-)
    Type 1 Excludes
    Type 2 Excludes
    • sepsis (due to) (in) actinomycotic (A42.7)
    • sepsis (due to) (in) anthrax (A22.7)
    • sepsis (due to) (in) candidal (B37.7)
    • sepsis (due to) (in) Erysipelothrix (A26.7)
    • sepsis (due to) (in) extraintestinal yersiniosis (A28.2)
    • sepsis (due to) (in) gonococcal (A54.86)
    • sepsis (due to) (in) herpesviral (B00.7)
    • sepsis (due to) (in) listerial (A32.7)
    • sepsis (due to) (in) melioidosis (A24.1)
    • sepsis (due to) (in) meningococcal (A39.2-A39.4)
    • sepsis (due to) (in) plague (A20.7)
    • sepsis (due to) (in) tularemia (A21.7)
    • toxic shock syndrome (A48.3)
    ICD-10-CM Diagnosis Code N71

    Inflammatory disease of uterus, except cervix

      2016 2017 2018 2019 Non-Billable/Non-Specific Code
    Includes
    • endo (myo) metritis
    • metritis
    • myometritis
    • pyometra
    • uterine abscess
    Type 1 Excludes
    • hyperplastic endometritis (N85.0-)
    • infection of uterus following delivery (O85, O86.-)
    Use Additional
    • code (B95-B97), to identify infectious agent
    ICD-10-CM Diagnosis Code K65

    Peritonitis

      2016 2017 2018 2019 Non-Billable/Non-Specific Code
    Code Also
    • if applicable diverticular disease of intestine (K57.-)
    Type 1 Excludes
    • acute appendicitis with generalized peritonitis (K35.2-)
    • aseptic peritonitis (T81.6)
    • benign paroxysmal peritonitis (E85.0)
    • chemical peritonitis (T81.6)
    • gonococcal peritonitis (A54.85)
    • neonatal peritonitis (P78.0-P78.1)
    • pelvic peritonitis, female (N73.3-N73.5)
    • periodic familial peritonitis (E85.0)
    • peritonitis due to talc or other foreign substance (T81.6)
    • peritonitis in chlamydia (A74.81)
    • peritonitis in diphtheria (A36.89)
    • peritonitis in syphilis (late) (A52.74)
    • peritonitis in tuberculosis (A18.31)
    • peritonitis with or following abortion or ectopic or molar pregnancy (O00-O07, O08.0)
    • peritonitis with or following appendicitis (K35.-)
    • puerperal peritonitis (O85)
    • retroperitoneal infections (K68.-)
    Use Additional
    • code (B95-B97), to identify infectious agent, if known
  • Type 2 Excludes: O75
    , O98
    ICD-10-CM Diagnosis Code O75

    Other complications of labor and delivery, not elsewhere classified

      2016 2017 2018 2019 Non-Billable/Non-Specific Code
    Type 2 Excludes
    • puerperal (postpartum) infection (O86.-)
    • puerperal (postpartum) sepsis (O85)
    ICD-10-CM Diagnosis Code O98

    Maternal infectious and parasitic diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium

      2016 2017 2018 2019 Non-Billable/Non-Specific Code
    Includes
    • the listed conditions when complicating the pregnant state, when aggravated by the pregnancy, or as a reason for obstetric care
    Type 2 Excludes
    • herpes gestationis (O26.4-)
    • infectious carrier state (O99.82-, O99.83-)
    • obstetrical tetanus (A34)
    • puerperal infection (O86.-)
    • puerperal sepsis (O85)
    • when the reason for maternal care is that the disease is known or suspected to have affected the fetus (O35-O36)
    Use Additional
    • code (Chapter 1), to identify specific infectious or parasitic disease

Diagnosis Index entries containing back-references to O85:
  • Abscess (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic) L02.91
    ICD-10-CM Diagnosis Code L02.91

    Cutaneous abscess, unspecified

      2016 2017 2018 2019 Billable/Specific Code
    • peritoneum, peritoneal (perforated) (ruptured) K65.1
      ICD-10-CM Diagnosis Code K65.1

      Peritoneal abscess

        2016 2017 2018 2019 Billable/Specific Code
      Applicable To
      • Abdominopelvic abscess
      • Abscess (of) omentum
      • Abscess (of) peritoneum
      • Mesenteric abscess
      • Retrocecal abscess
      • Subdiaphragmatic abscess
      • Subhepatic abscess
      • Subphrenic abscess
      • puerperal, postpartum, childbirth O85
  • Infection, infected, infective (opportunistic) B99.9
    ICD-10-CM Diagnosis Code B99.9

    Unspecified infectious disease

      2016 2017 2018 2019 Billable/Specific Code
    • major
      • puerperal, postpartum, childbirth O85
    • puerperal O86.4
      ICD-10-CM Diagnosis Code O86.4

      Pyrexia of unknown origin following delivery

        2016 2017 2018 2019 Billable/Specific Code Maternity Dx (12-55 years) Female Dx
      Applicable To
      • Puerperal infection NOS following delivery
      • Puerperal pyrexia NOS following delivery
      Type 2 Excludes
      • pyrexia during labor (O75.2)
      • major or generalized O85
  • Pelviperitonitis - see also Peritonitis, pelvic
    • puerperal O85
  • Peritonitis (adhesive) (bacterial) (fibrinous) (hemorrhagic) (idiopathic) (localized) (perforative) (primary) (with adhesions) (with effusion) K65.9
    ICD-10-CM Diagnosis Code K65.9

    Peritonitis, unspecified

      2016 2017 2018 2019 Billable/Specific Code
    Applicable To
    • Bacterial peritonitis NOS
    • puerperal, postpartum, childbirth O85
  • Puerperal, puerperium (complicated by, complications)
    • abscess
      • peritoneum O85
    • fever (of unknown origin) O86.4
      ICD-10-CM Diagnosis Code O86.4

      Pyrexia of unknown origin following delivery

        2016 2017 2018 2019 Billable/Specific Code Maternity Dx (12-55 years) Female Dx
      Applicable To
      • Puerperal infection NOS following delivery
      • Puerperal pyrexia NOS following delivery
      Type 2 Excludes
      • pyrexia during labor (O75.2)
      • septic O85
    • infection O86.4
      ICD-10-CM Diagnosis Code O86.4

      Pyrexia of unknown origin following delivery

        2016 2017 2018 2019 Billable/Specific Code Maternity Dx (12-55 years) Female Dx
      Applicable To
      • Puerperal infection NOS following delivery
      • Puerperal pyrexia NOS following delivery
      Type 2 Excludes
      • pyrexia during labor (O75.2)
      • generalized O85
      • peritoneum O85
    • metroperitonitis O85
    • parametritis O85
    • pelviperitonitis O85
    • peritoneal infection O85
    • peritonitis O85 (pelvic)
    • pyemia O85
    • pyohemia O85
    • salpingoperitonitis O85
    • sepsis O85 (pelvic)
    • sepsis O85
  • Pyemia, pyemic (fever) (infection) (purulent) - see also Sepsis
    • puerperal, postpartum, childbirth O85
  • Sepsis (generalized) (unspecified organism) A41.9
    ICD-10-CM Diagnosis Code A41.9

    Sepsis, unspecified organism

      2016 2017 2018 2019 Billable/Specific Code
    Applicable To
    • Septicemia NOS
    • pelvic, puerperal, postpartum, childbirth O85
    • puerperal, postpartum, childbirth O85 (pelvic)

ICD-10-CM Codes Adjacent To O85
O75.89 Other specified complications of labor and delivery
O75.9 Complication of labor and delivery, unspecified
O76 Abnormality in fetal heart rate and rhythm complicating labor and delivery
O77 Other fetal stress complicating labor and delivery
O77.0 Labor and delivery complicated by meconium in amniotic fluid
O77.1 Fetal stress in labor or delivery due to drug administration
O77.8 Labor and delivery complicated by other evidence of fetal stress
O77.9 Labor and delivery complicated by fetal stress, unspecified
O80 Encounter for full-term uncomplicated delivery
O82 Encounter for cesarean delivery without indication
O85 Puerperal sepsis
O86 Other puerperal infections
O86.0 Infection of obstetric surgical wound
O86.00 …… unspecified
O86.01 …… superficial incisional site
O86.02 …… deep incisional site
O86.03 …… organ and space site
O86.04 Sepsis following an obstetrical procedure
O86.09 …… other surgical site
O86.1 Other infection of genital tract following delivery
O86.11 Cervicitis following delivery

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.

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