O85 vs O86.1
O85 (Puerperal sepsis) compared with O86.1 (Other infection of genital tract following delivery), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Can these codes be reported together?
Yes, when both are documented. O85 carries an Excludes2 note covering O86.1: “genital tract infection following delivery (O86.1-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| O85Puerperal sepsis | O86.1Other infection of genital tract following delivery | |
|---|---|---|
| Billing status | Billable | Non-billable header |
| Classification | O00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A) | O00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A) |
| Definition | Puerperal sepsis is a billable ICD-10-CM diagnosis code (O85). | Other infection of genital tract following delivery is a non-billable ICD-10-CM category code (O86.1). |
| Includes | Postpartum sepsis Puerperal peritonitis Puerperal pyemia | — |
| Use additional code | code (B95-B97), to identify infectious agent code (R65.2-) to identify severe sepsis, if applicable | code (B95-B97), to identify infectious agent |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources