O86.0 vs T81.49XA

O86.0 (Infection of obstetric surgical wound) compared with T81.49XA (Infection following a procedure, other surgical site, initial encounter), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Relationship

Conflict

Excludes1 conflict

O86.0

Infection of obstetric surgical wound

↔

T81.49XA

Infection following a procedure, other surgical site, initial encounter

Not coded here — these two are mutually exclusive.

“complications of procedures, not elsewhere classified (T81.4-)”

An Excludes1 note means the two conditions cannot occur together, so the pair should not be reported for the same encounter. The sole exception is when the conditions are documented as unrelated to each other.

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

Informational

Excludes2 relationship

T81.49XA

Infection following a procedure, other surgical site, initial encounter

↔

O86.0

Infection of obstetric surgical wound

Distinct conditions — both may be reported.

“obstetric surgical wound infection (O86.0-)”

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source: CMS ICD-10-CM tabular instructional notes

Can these codes be reported together?

No — do not report together. O86.0 carries an Excludes1 note covering T81.49XA: “complications of procedures, not elsewhere classified (T81.4-)”

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

Yes, when both are documented. T81.49XA carries an Excludes2 note covering O86.0: “obstetric surgical wound infection (O86.0-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

	O86.0Infection of obstetric surgical wound	T81.49XAInfection following a procedure, other surgical site, initial encounter
Billing status	Non-billable header	Billable
Classification	O00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A)	S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
Definition	Infection of obstetric surgical wound is a non-billable ICD-10-CM category code (O86.0).	Infection following a procedure, other surgical site, initial encounter is a billable ICD-10-CM diagnosis code (T81.49A).
7th character	—	The appropriate 7th character is to be added to each code from category T81
Includes	Infected cesarean delivery wound following delivery Infected perineal repair following delivery	—
Use additional code	code (B95-B97), to identify infectious agent	code to identify infection code (R65.2-) to identify severe sepsis, if applicable code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

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Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources