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Compare/O85 vs O86.81

O85 vs O86.81

O85 (Puerperal sepsis) compared with O86.81 (Puerperal septic thrombophlebitis), 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. O85 carries an Excludes1 note covering O86.81: “puerperal septic thrombophlebitis (O86.81)”

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

O85Puerperal sepsisO86.81Puerperal septic thrombophlebitis
Billing statusBillableBillable
ClassificationO00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A)O00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A)
DefinitionPuerperal sepsis is a billable ICD-10-CM diagnosis code (O85).Puerperal septic thrombophlebitis is a billable ICD-10-CM diagnosis code (O86.81).
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