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O03 ICD-10-CM Code: Spontaneous abortion

Compare with another code for O03Check this code on a claim

Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Coding at a Glance

Official instructions
1 inclusion term · 1 Excludes1

What these terms mean →

Category · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

Excludes1from O00-O08Not reported with this code unless documented as unrelated
  • continuing pregnancy in multiple gestation after abortion of one fetus or more (O31.1-, O31.3-)
IncludesWhat this code covers
  • miscarriage

Where it sits Source: CMS/NCHS

Under:Chapter 15: Pregnancy, Childbirth and the PuerperiumO00-O08 Pregnancy with abortive outcome

Codes under O03 (10)

  • O03.0Genital tract and pelvic infection following incomplete spontaneous abortionBillable
  • O03.1Delayed or excessive hemorrhage following incomplete spontaneous abortionBillable
  • O03.2Embolism following incomplete spontaneous abortionBillable
  • O03.3Other and unspecified complications following incomplete spontaneous abortionNot billable
  • O03.4Incomplete spontaneous abortion without complicationBillable
  • O03.5Genital tract and pelvic infection following complete or unspecified spontaneous abortionBillable
  • O03.6Delayed or excessive hemorrhage following complete or unspecified spontaneous abortionBillable
  • O03.7Embolism following complete or unspecified spontaneous abortionBillable
  • O03.8Other and unspecified complications following complete or unspecified spontaneous abortionNot billable
  • O03.9Complete or unspecified spontaneous abortion without complicationBillable

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for O03 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on O03 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • miscarriage

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from O00-O08

Coder workflow for O03

MedCoder structured workflow — derived from this code’s own official record

Before you code O03

  1. O03 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewO03.0, O03.1, O03.2, O03.3, O03.4, O03.5, O03.6, O03.7, O03.8, O03.9

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. Confirm the condition is documented as complicating the pregnancy, childbirth, or the puerperium, and check the trimester where the code carries one and the fetus character where the category requires it. Chapter 15 codes belong on the maternal record only and take sequencing priority over codes from other chapters. It is the provider’s responsibility to state that a condition is not affecting the pregnancy; the trimester is assigned from the documentation (Guidelines I.C.15.a, I.C.15.a.1, I.C.15.a.3).

    Guide: How to choose an ICD-10-CM code →

  3. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with the code beneath O03. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support one of the more specific codes beneath O03?
    Yes → Select that code and continue the checks below on its own page.
    No → O03 cannot be reported as written. Where the codes beneath it include an unspecified code, that code applies when the record goes no further; otherwise query for the missing detail.

    ReviewO03.0, O03.1, O03.2, O03.3, O03.4, O03.5, O03.6, O03.7, O03.8, O03.9

  2. Does the documentation support a condition named in O03’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewO31.1, O31.3

Report the code beneath O03 that the documentation supports, not O03 itself. Then confirm that code is valid for the date of service on its own page.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Trimester
Assigned from the documented trimester at the encounter, or the trimester in which the condition developed for inpatient stays (Guidelines I.C.15.a.3).

Official instructions as workflow

  • Excludes1 — check before selecting O03(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with O03: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareO31.1, O31.3

    See the official tabular notes · Guidelines I.A.12.a

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition O03 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewO31.1, O31.3

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse O03 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of O03 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • O31.1— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of continuing pregnancy in multiple gestation after abortion of one fetus or more moves the case to O31.1; the two are not reported together unless documented as unrelated.

    Full comparison: O03 vs O31.1 →

  • O31.3— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of continuing pregnancy in multiple gestation after abortion of one fetus or more moves the case to O31.3; the two are not reported together unless documented as unrelated.

    Full comparison: O03 vs O31.3 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Spontaneous abortion is a non-billable ICD-10-CM category code (O03). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A)

2) Retained Products of Conception following an abortion Subsequent encounters for retained products of conception following a spontaneous abortion or elective termination of pregnancy, without complications are assigned O03.4, Incomplete spontaneous abortion without complication, or code O07.4, Failed attempted termination of pregnancy without complication. This advice is appropriate even when the patient was discharged previously with a discharge diagnosis of complete abortion. If the patient has a specific complication associated with the spontaneous abortion or elective termination of pregnancy in addition to retained products of conception, assign the appropriate complication code (e.g., O03.-, O04.-, O07.-) instead of code O03.4 or O07.4.

Verify Before Coding

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name O03 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 21 Excludes1 notes across 7 chapters: G08 — Intracranial and intraspinal phlebitis and thrombophlebitis, K65 — Peritonitis, N70 — Salpingitis and oophoritis, N70-N77 — Inflammatory diseases of female pelvic organs (N70-N77), N71 — Inflammatory disease of uterus, except cervix, N72 — Inflammatory disease of cervix uteri, N73 — Other female pelvic inflammatory diseases, N74 — Female pelvic inflammatory disorders in diseases classified elsewhere, N75 — Diseases of Bartholin's gland, N76 — Other inflammation of vagina and vulva, N77 — Vulvovaginal ulceration and inflammation in diseases classified elsewhere, O20 — Hemorrhage in early pregnancy, R34 — Anuria and oliguria, R55 — Syncope and collapse, R57 — Shock, not elsewhere classified, T79.0 — Air embolism (traumatic), T79.1 — Fat embolism (traumatic), T79.4 — Traumatic shock, T81.1 — Postprocedural shock, T81.7 — Vascular complications following a procedure, not elsewhere classified, +1 more.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 18 Excludes2 notes across 4 chapters: D65 — Disseminated intravascular coagulation [defibrination syndrome], D68 — Other coagulation defects, I26 — Pulmonary embolism, K72 — Hepatic failure, not elsewhere classified, N17 — Acute kidney failure, N17-N19 — Acute kidney failure and chronic kidney disease (N17-N19), N18 — Chronic kidney disease (CKD), N19 — Unspecified kidney failure, N30 — Cystitis, N30-N39 — Other diseases of the urinary system (N30-N39), N31 — Neuromuscular dysfunction of bladder, not elsewhere classified, N32 — Other disorders of bladder, N33 — Bladder disorders in diseases classified elsewhere, N34 — Urethritis and urethral syndrome, N35 — Urethral stricture, N36 — Other disorders of urethra, N37 — Urethral disorders in diseases classified elsewhere, N39 — Other disorders of urinary system.

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 6 Code First instructions: I47 — Paroxysmal tachycardia, I49 — Other cardiac arrhythmias, I50 — Heart failure, I74 — Arterial embolism and thrombosis, I80 — Phlebitis and thrombophlebitis, I82 — Other venous embolism and thrombosis.

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

Contextual Map

Every relationship of O03 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run O03 with these 24 related codes in Claim Check

Hierarchy

Excludes1

Referenced by Excludes1 notes (21)

Referenced by Excludes2 notes (18)

Referenced by Code First instructions

  • I47 — Paroxysmal tachycardia[Code First]: “abortion or ectopic or molar pregnancy (O00-O07, O08.8)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
  • I49 — Other cardiac arrhythmias[Code First]: “abortion or ectopic or molar pregnancy (O00-O07, O08.8)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
  • I50 — Heart failure[Code First]: “heart failure complicating abortion or ectopic or molar pregnancy (O00-O07, O08.8)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
  • I74 — Arterial embolism and thrombosis[Code First]: “embolism and thrombosis complicating abortion or ectopic or molar pregnancy (O00-O07, O08.2)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
  • I80 — Phlebitis and thrombophlebitis[Code First]: “, if applicable: phlebitis and thrombophlebitis complicating abortion, ectopic or molar pregnancy (O00-O07, O08.7)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
  • I82 — Other venous embolism and thrombosis[Code First]: “abortion, ectopic or molar pregnancy (O00-O07, O08.7)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Nearest codes (30)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Common coding questions

MedCoder editorial

Can O03 be billed directly?

No. O03 (Spontaneous abortion) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "O03 — Spontaneous abortion." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/o03-spontaneous-abortion

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Spontaneous abortion

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to O03 in its code family, with their registry titles.