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O07.0 vs O31.3

O07.0 (Genital tract and pelvic infection following failed attempted termination of pregnancy) compared with O31.3 (Continuing pregnancy after elective fetal reduction of one fetus or more), from the official CMS tabular data.

Summary

These codes should not be reported together because O07.0’s tabular entry lists O31.3 under Excludes1.

Official rule
What is different?

The conditions named and billing status.O07.0 is “Genital tract and pelvic infection following failed attempted termination of pregnancy”; O31.3 is “Continuing pregnancy after elective fetal reduction of one fetus or more”. O31.3 is a non-billable header; O07.0 is billable.

Registry fact

Can these codes be reported together?

No.O07.0’s entry carries an Excludes1 note covering O31.3: “continuing pregnancy in multiple gestation after abortion of one fetus or more (O31.1-, O31.3-)”. Both may be reported only when the documentation shows the two conditions are unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

Yes.O07.0’s tabular entry: “continuing pregnancy in multiple gestation after abortion of one fetus or more (O31.1-, O31.3-)”. The note covers O31.3.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes2 relationship?

None.Neither entry carries an Excludes2 note that names the other code. O31.3 carries 3 Excludes2 notes covering other codes; the side-by-side table quotes them.

Official rule

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

One is a header.O31.3 is a non-billable header, but O07.0 is not one of its subdivisions.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Excludes1 — generally not reported together

Excludes1 conflict

O07.0
Genital tract and pelvic infection following failed attempted termination of pregnancy
O31.3
Continuing pregnancy after elective fetal reduction of one fetus or more

What we found

No — do not report together.O07.0 carries an Excludes1 note covering O31.3: “continuing pregnancy in multiple gestation after abortion of one fetus or more (O31.1-, O31.3-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

What to review

Report one of the two. Both may be reported only when the documentation shows the two conditions are unrelated to each other.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes1 note means the two conditions are not ordinarily reported together for the same encounter, because the classification treats them as mutually exclusive forms of the same condition. The documented exception is when the two conditions are unrelated to each other.

Source / rule

CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a

Official guidance behind these answers

  • Section I.A.12.a — Excludes1 · applies to: Excludes1

    A type 1 Excludes note is a pure excludes note. It means “NOT CODED HERE!” An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. An exception to the Excludes1 definition is the circumstance when the two conditions are unrelated to each other. If it is not clear whether the two conditions involving an Excludes1 note are related or not, query the provider. For example, code F45.8, Other somatoform disorders, has an Excludes1 note for "sleep related teeth grinding (G47.63)," because "teeth grinding" is an inclusion term under F45.8. Only one of these two codes should be assigned for teeth grinding. However psychogenic dysmenorrhea is also an inclusion term under F45.8, and a patient could have both this condition and sleep related teeth grinding. In this case, the two conditions are clearly unrelated to each other, and so it would be appropriate to report F45.8 and G47.63 together.

    ICD-10-CM Official Guidelines FY2026

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

O07.0Genital tract and pelvic infection following failed attempted termination of pregnancyO31.3Continuing pregnancy after elective fetal reduction of one fetus or more
Billing statusBillableNon-billable header

Report instead: O31.30X0, O31.30X1, O31.30X2, O31.30X3, O31.30X4

ClassificationO00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A)O00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A)
DefinitionGenital tract and pelvic infection following failed attempted termination of pregnancy is a billable ICD-10-CM diagnosis code (O07.0).Continuing pregnancy after elective fetal reduction of one fetus or more is a non-billable ICD-10-CM category code (O31.3).
7th characterOne of the following 7th characters is to be assigned to each code under category O31. 7th character 0 is for single gestations and multiple gestations where the fetus is unspecified. 7th characters 1 through 9 are for cases of multiple gestations to identify the fetus for which the code applies. The appropriate code from category O30, Multiple gestation, must also be assigned when assigning a code from category O31 that has a 7th character of 1 through 9.
Includes
failure of attempted induction of termination of pregnancy
incomplete elective abortion
Endometritis following failed attempted termination of pregnancy
Oophoritis following failed attempted termination of pregnancy
Continuing pregnancy after selective termination of one fetus or more
Excludes1
sepsis following failed attempted termination of pregnancy (O07.37)
urinary tract infection following failed attempted termination of pregnancy (O07.38)
incomplete spontaneous abortion (O03.0-)
continuing pregnancy in multiple gestation after abortion of one fetus or more (O31.1-, O31.3-)
Excludes2
delayed delivery of second twin, triplet, etc. (O63.2)
malpresentation of one fetus or more (O32.9)
placental transfusion syndromes (O43.0-)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources