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O03.37 ICD-10-CM Code: Sepsis following incomplete spontaneous abortion

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
1 inclusion term · 2 Excludes1 · 2 use-additional codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 770 — ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY (MDC 14)
  • MS-DRG 779 — ABORTION WITHOUT D&C (MDC 14)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for O03.37 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 O03.37 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

Source: inherited from O03

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).

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code to identify infectious agent (B95-B97)
  • Use additional code to identify severe sepsis, if applicable (R65.2-)

Coder workflow for O03.37

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

Before you code O03.37

  1. 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 →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with O03.37. 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 a condition named in O03.37’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.

    ReviewO03.2, O31.1, O31.3

Consider O03.37. Then work the Use Additional Code note, and 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).
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

  • Excludes1 — check before selecting O03.37(2 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with O03.37: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareO03.2, O31.1, O31.3

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

  • Use Additional Code — after identifying O03.37(2 notes)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with O03.37 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewR65.2

    See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

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

Documentation: Both the condition O03.37 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).

ReviewO03.2, O31.1, O31.3

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with O03.37?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

ReviewR65.2

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

Sepsis following incomplete spontaneous abortion is a billable ICD-10-CM diagnosis code (O03.37).

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

Indexed Clinical Terms (1)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

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

  • Age-restricted: the Medicare Code Editor lists this as a maternity (age 9-64) diagnosis; other ages are presumed incorrect.
  • CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

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 O03.37 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 22 Excludes1 notes across 6 chapters: G08 — Intracranial and intraspinal phlebitis and thrombophlebitis (via O03.-), K65 — Peritonitis (via O03.-), N70 — Salpingitis and oophoritis (via O03.-), N70-N77 — Inflammatory diseases of female pelvic organs (N70-N77) (via O03.-), N71 — Inflammatory disease of uterus, except cervix (via O03.-), N72 — Inflammatory disease of cervix uteri (via O03.-), N73 — Other female pelvic inflammatory diseases (via O03.-), N74 — Female pelvic inflammatory disorders in diseases classified elsewhere (via O03.-), N75 — Diseases of Bartholin's gland (via O03.-), N76 — Other inflammation of vagina and vulva (via O03.-), N77 — Vulvovaginal ulceration and inflammation in diseases classified elsewhere (via O03.-), O03.0 — Genital tract and pelvic infection following incomplete spontaneous abortion, O03.31 — Shock following incomplete spontaneous abortion, O20 — Hemorrhage in early pregnancy (via O03.-), R34 — Anuria and oliguria (via O03.-), R55 — Syncope and collapse (via O03.-), R57 — Shock, not elsewhere classified (via O03.-), T79.0 — Air embolism (traumatic) (via O03.-), T79.1 — Fat embolism (traumatic) (via O03.-), T79.4 — Traumatic shock (via O03.-), +2 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] (via O03.-), D68 — Other coagulation defects (via O03.-), I26 — Pulmonary embolism (via O03.-), K72 — Hepatic failure, not elsewhere classified (via O03.-), N17 — Acute kidney failure (via O03.-), N17-N19 — Acute kidney failure and chronic kidney disease (N17-N19) (via O03.-), N18 — Chronic kidney disease (CKD) (via O03.-), N19 — Unspecified kidney failure (via O03.-), N30 — Cystitis (via O03.-), N30-N39 — Other diseases of the urinary system (N30-N39) (via O03.-), N31 — Neuromuscular dysfunction of bladder, not elsewhere classified (via O03.-), N32 — Other disorders of bladder (via O03.-), N33 — Bladder disorders in diseases classified elsewhere (via O03.-), N34 — Urethritis and urethral syndrome (via O03.-), N35 — Urethral stricture (via O03.-), N36 — Other disorders of urethra (via O03.-), N37 — Urethral disorders in diseases classified elsewhere (via O03.-), N39 — Other disorders of urinary system (via O03.-).

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

Referenced by 9 Code First instructions across 3 chapters: A40 — Streptococcal sepsis, A41 — Other sepsis, I47 — Paroxysmal tachycardia (via O03.-), I49 — Other cardiac arrhythmias (via O03.-), I50 — Heart failure (via O03.-), I74 — Arterial embolism and thrombosis (via O03.-), I80 — Phlebitis and thrombophlebitis (via O03.-), I82 — Other venous embolism and thrombosis (via O03.-), R65.2 — Severe sepsis.

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.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 311 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 2 MS-DRGs: DRG 770 (MDC 14), DRG 779 (MDC 14).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):PRG003 — Spontaneous abortion and complications of spontaneous abortion (default); INF002 — Septicemia.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Spontaneous abortion and complications of spontaneous abortion, Septicemia).

O03.0 — Genital tract and pelvic infection following incomplete spontaneous abortion, O03.1 — Delayed or excessive hemorrhage following incomplete spontaneous abortion, O03.2 — Embolism following incomplete spontaneous abortion, O03.30 — Unspecified complication following incomplete spontaneous abortion, O03.31 — Shock following incomplete spontaneous abortion, O03.32 — Renal failure following incomplete spontaneous abortion, O03.33 — Metabolic disorder following incomplete spontaneous abortion, O03.34 — Damage to pelvic organs following incomplete spontaneous abortion, O03.35 — Other venous complications following incomplete spontaneous abortion, O03.36 — Cardiac arrest following incomplete spontaneous abortion, O03.38 — Urinary tract infection following incomplete spontaneous abortion, O03.39 — Incomplete spontaneous abortion with other complications, O03.4 — Incomplete spontaneous abortion without complication, O03.5 — Genital tract and pelvic infection following complete or unspecified spontaneous abortion, O03.6 — Delayed or excessive hemorrhage following complete or unspecified spontaneous abortion, O03.7 — Embolism following complete or unspecified spontaneous abortion, O03.80 — Unspecified complication following complete or unspecified spontaneous abortion, O03.81 — Shock following complete or unspecified spontaneous abortion, O03.82 — Renal failure following complete or unspecified spontaneous abortion, O03.83 — Metabolic disorder following complete or unspecified spontaneous abortion, +56 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Abortion”; these codes share that main term but sit in a different category of the Tabular List.

N96 — Recurrent pregnancy loss (habitual or recurrent), O00.10 — Tubal pregnancy without intrauterine pregnancy (tubal), O00.11 — Tubal pregnancy with intrauterine pregnancy (tubal, with intrauterine pregnancy), O02.1 — Missed abortion (missed), O04.5 — Genital tract and pelvic infection following (induced) termination of pregnancy (induced, complicated by, oophoritis), O04.6 — Delayed or excessive hemorrhage following (induced) termination of pregnancy (induced, complicated by, hemolysis), O04.7 — Embolism following (induced) termination of pregnancy (induced, complicated by, embolism), O04.80 — (Induced) termination of pregnancy with unspecified complications (induced, complicated by), O04.81 — Shock following (induced) termination of pregnancy (induced, complicated by, shock), O04.82 — Renal failure following (induced) termination of pregnancy (induced, complicated by, uremia), O04.83 — Metabolic disorder following (induced) termination of pregnancy (induced, complicated by, metabolic disorder), O04.84 — Damage to pelvic organs following (induced) termination of pregnancy (induced, complicated by, laceration of pelvic organ), O04.85 — Other venous complications following (induced) termination of pregnancy (induced, complicated by, venous complication NEC), O04.86 — Cardiac arrest following (induced) termination of pregnancy (induced, complicated by, cardiac arrest), O04.87 — Sepsis following (induced) termination of pregnancy (induced, complicated by, sepsis), O04.88 — Urinary tract infection following (induced) termination of pregnancy (induced, complicated by, cystitis), O04.89 — (Induced) termination of pregnancy with other complications (induced, complicated by, specified condition NEC), O07.0 — Genital tract and pelvic infection following failed attempted termination of pregnancy (attempted, complicated by, oophoritis), O07.1 — Delayed or excessive hemorrhage following failed attempted termination of pregnancy (attempted, complicated by, hemolysis), O07.2 — Embolism following failed attempted termination of pregnancy (attempted, complicated by, embolism), +14 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Partial Thromboplastin Time (PTT) Test, Pregnancy Test

Contextual Map

Every relationship of O03.37 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 O03.37 with these 24 related codes in Claim Check

Hierarchy

Excludes1

Use Additional Code

Referenced by Excludes1 notes (22)

Referenced by Excludes2 notes (18)

  • D65 — Disseminated intravascular coagulation [defibrination syndrome][Excludes2](via O03.-): “abortion or ectopic or molar pregnancy (O00-O07, O08.1)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • D68 — Other coagulation defects[Excludes2](via O03.-): “coagulation defects complicating abortion or ectopic or molar pregnancy (O00-O07, O08.1)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • I26 — Pulmonary embolism[Excludes2](via O03.-): “pulmonary embolism complicating abortion, ectopic or molar pregnancy (O00-O07, O08.2)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • K72 — Hepatic failure, not elsewhere classified[Excludes2](via O03.-): “hepatic failure complicating abortion or ectopic or molar pregnancy (O00-O07, O08.8)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • N17 — Acute kidney failure[Excludes2](via O03.-): “renal failure complicating abortion or ectopic or molar pregnancy (O00-O07, O08.4)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • N17-N19 — Acute kidney failure and chronic kidney disease (N17-N19)[Excludes2](via O03.-): “renal failure complicating abortion or ectopic or molar pregnancy (O00-O07, O08.4)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • N18 — Chronic kidney disease (CKD)[Excludes2](via O03.-): “renal failure complicating abortion or ectopic or molar pregnancy (O00-O07, O08.4)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • N19 — Unspecified kidney failure[Excludes2](via O03.-): “renal failure complicating abortion or ectopic or molar pregnancy (O00-O07, O08.4)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • and 10 more

Referenced by Code First instructions (9)

  • A40 — Streptococcal sepsis[Code First]: “streptococcal sepsis following abortion or ectopic or molar pregnancy (O03.37, O03.87, O04.87, O07.37, O08.82)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • A41 — Other sepsis[Code First]: “sepsis following abortion, ectopic or molar pregnancy (O03.37, O03.87, O04.87, O07.37, O08.82)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • I47 — Paroxysmal tachycardia[Code First](via O03.-): “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](via O03.-): “abortion or ectopic or molar pregnancy (O00-O07, O08.8)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • I50 — Heart failure[Code First](via O03.-): “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](via O03.-): “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](via O03.-): “, 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](via O03.-): “abortion, ectopic or molar pregnancy (O00-O07, O08.7)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • and 1 more

Clinical classification (CCSR)

MS-DRG Grouper

  • CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2026
  • DRG 770 — ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY[MS-DRG]: “ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY (MDC 14)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
  • DRG 779 — ABORTION WITHOUT D&C[MS-DRG]: “ABORTION WITHOUT D&C (MDC 14)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

  • MDC 14 — Pregnancy, Childbirth and the Puerperium[MDC crossing]: “Pregnancy, Childbirth and the Puerperium — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 94 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Abortion (complete) (spontaneous), incomplete (spontaneous), complicated (by) (following), sepsis[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · 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

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
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 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. "O03.37 — Sepsis following incomplete spontaneous abortion." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/o03.37-sepsis-following-incomplete-spontaneous-abortion

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Sepsis following incomplete 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 O03.37 in its code family, with their registry titles.

View all codes in the O03 family