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O03 ICD-10-CM Code: Spontaneous abortion

Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.

Coding at a Glance

Tabular directives
1 inclusion term · 1 Excludes1

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: FY2026Effective: October 1, 2025

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 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; query for the specificity its subcategory needs.

    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

Consider O03. Then confirm the code is valid for the date of service in the Verify section.

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.

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

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 structured 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-fy2026
  • I49 — Other cardiac arrhythmias[Code First]: “abortion or ectopic or molar pregnancy (O00-O07, O08.8)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • 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-fy2026
  • 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-fy2026
  • 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-fy2026
  • 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-fy2026

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

Common coding questions

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 FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 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 structured 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 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.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

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 FY2026. 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 (effective October 1, 2026), 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.