O04.5 vs O04.87
O04.5 (Genital tract and pelvic infection following (induced) termination of pregnancy) compared with O04.87 (Sepsis following (induced) termination of pregnancy), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. O04.5 carries an Excludes1 note covering O04.87: “sepsis following (induced) termination of pregnancy (O04.87)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Side by side
| O04.5Genital tract and pelvic infection following (induced) termination of pregnancy | O04.87Sepsis following (induced) termination of pregnancy | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | O00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A) | O00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A) |
| Definition | Genital tract and pelvic infection following (induced) termination of pregnancy is a billable ICD-10-CM diagnosis code (O04.5). | Sepsis following (induced) termination of pregnancy is a billable ICD-10-CM diagnosis code (O04.87). |
| Includes | complications following (induced) termination of pregnancy Endometritis following (induced) termination of pregnancy Oophoritis following (induced) termination of pregnancy Parametritis following (induced) termination of pregnancy | complications following (induced) termination of pregnancy |
| Use additional code | — | code to identify infectious agent (B95-B97) code to identify severe sepsis, if applicable (R65.2-) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources