O86.00 ICD-10-CM Code: Infection of obstetric surgical wound, unspecified
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Inpatient Payment Groups (MS-DRG)
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.
- MS-DRG 769 — POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES (MDC 14)
- MS-DRG 776 — POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES (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.
Official Registry Overview & Definition
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for O86.00 in the official ICD-10-CM tabular list.
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).
- complications of procedures, not elsewhere classified (T81.4-) Compare O86.00 vs T81.4 →
- postprocedural fever NOS (R50.82) Compare O86.00 vs R50.82 →
- postprocedural retroperitoneal abscess (K68.11) Compare O86.00 vs K68.11 →
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- infection during labor (O75.3) Compare O86.00 vs O75.3 →
- obstetrical tetanus (A34) Compare O86.00 vs A34 →
- mental and behavioral disorders associated with the puerperium (F53.-) Compare O86.00 vs F53 →
- puerperal osteomalacia (M83.0) Compare O86.00 vs M83.0 →
Frequently Compared Codes
The official Excludes notes on O86.00 name these codes. Each comparison page covers when the two can — or must not — be reported together.
Change history
- FY2019 — 2018-10-01Added to the code setInfection of obstetric surgical wound, unspecifiedFY2019 changes
Verify Before Coding
- Age-restricted: the Medicare Code Editor lists this as a maternity (age 9-64) diagnosis; other ages are presumed incorrect.
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.
Contextual Map
Every relationship of O86.00 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.
Hierarchy
- O00-O9A — Chapter 15: Pregnancy, Childbirth and the Puerperium (O00-O9A) (O00-O9A) [Hierarchy]
- O85-O92 — Complications predominantly related to the puerperium [Hierarchy]
- O86 — Clinical Diagnosis [Hierarchy]
- O86.0 — Clinical Diagnosis [Hierarchy]
Referenced by Excludes1 notes (9)
- N70 — Salpingitis and oophoritis [Excludes1](via O86.-): “pregnancy, childbirth and the puerperium (O23.-, O75.3, O85, O86.-)” · check together
- N70-N77 — Inflammatory diseases of female pelvic organs (N70-N77) [Excludes1](via O86.-): “pregnancy, childbirth and the puerperium (O23.-, O75.3, O85, O86.-)” · check together
- N71 — Inflammatory disease of uterus, except cervix [Excludes1](via O86.-): “infection of uterus following delivery (O85, O86.-)” · check together
- N72 — Inflammatory disease of cervix uteri [Excludes1](via O86.-): “pregnancy, childbirth and the puerperium (O23.-, O75.3, O85, O86.-)” · check together
- N73 — Other female pelvic inflammatory diseases [Excludes1](via O86.-): “pregnancy, childbirth and the puerperium (O23.-, O75.3, O85, O86.-)” · check together
- N74 — Female pelvic inflammatory disorders in diseases classified elsewhere [Excludes1](via O86.-): “pregnancy, childbirth and the puerperium (O23.-, O75.3, O85, O86.-)” · check together
- N75 — Diseases of Bartholin's gland [Excludes1](via O86.-): “pregnancy, childbirth and the puerperium (O23.-, O75.3, O85, O86.-)” · check together
- N76 — Other inflammation of vagina and vulva [Excludes1](via O86.-): “pregnancy, childbirth and the puerperium (O23.-, O75.3, O85, O86.-)” · check together
- and 1 more
Referenced by Excludes2 notes
- O75 — Other complications of labor and delivery, not elsewhere classified [Excludes2](via O86.-): “puerperal (postpartum) infection (O86.-)” · check together
- O75.4 — Other complications of obstetric surgery and procedures [Excludes2](via O86.0.-): “infection of obstetrical (surgical) wound (O86.0-)” · check together
- O98 — Maternal infectious and parasitic diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium [Excludes2](via O86.-): “puerperal infection (O86.-)” · check together
- T81.4 — Infection following a procedure [Excludes2](via O86.0.-): “obstetric surgical wound infection (O86.0-)” · check together
Clinical classification (CCSR)
- PRG023 — Complications specified during childbirth [CCSR]
Potential MS-DRG
- DRG 769 — POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES [MS-DRG]: “POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES (MDC 14)”
- DRG 776 — POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES [MS-DRG]: “POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES (MDC 14)”
MDC crossing · procedures (94)
- 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.”
- 0U570ZZ — Destruction of Bilateral Fallopian Tubes, Open Approach [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Open Approach — grouped in MDC 14, the procedure side of this code's crossing.” · check together
- 0U573ZZ — Destruction of Bilateral Fallopian Tubes, Percutaneous Approach [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Percutaneous Approach — grouped in MDC 14, the procedure side of this code's crossing.” · check together
- 0U574ZZ — Destruction of Bilateral Fallopian Tubes, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Percutaneous Endoscopic Approach — grouped in MDC 14, the procedure side of this code's crossing.” · check together
- 0U577ZZ — Destruction of Bilateral Fallopian Tubes, Via Natural or Artificial Opening [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Via Natural or Artificial Opening — grouped in MDC 14, the procedure side of this code's crossing.” · check together
- 0U578ZZ — Destruction of Bilateral Fallopian Tubes, Via Natural or Artificial Opening Endoscopic [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Via Natural or Artificial Opening Endoscopic — grouped in MDC 14, the procedure side of this code's crossing.” · check together
- and 89 more
Index entries
- Complication (s) (from) (of), cesarean delivery wound NEC, infection (following delivery)[Index term]
- Complication (s) (from) (of), obstetric, surgical wound NEC, infection[Index term]
- Infection, infected, infective (opportunistic), cesarean delivery wound (puerperal)[Index term]
- Infection, infected, infective (opportunistic), obstetrical surgical wound (puerperal)[Index term]
Nearest codes (21)
- O86 — Other puerperal infections [Sibling]
- O86.0 — Infection of obstetric surgical wound [Sibling]
- O86.01 — Infection of obstetric surgical wound, superficial incisional site [Sibling]
- O86.02 — Infection of obstetric surgical wound, deep incisional site [Sibling]
- O86.03 — Infection of obstetric surgical wound, organ and space site [Sibling]
- O86.04 — Sepsis following an obstetrical procedure [Sibling]
- O86.09 — Infection of obstetric surgical wound, other surgical site [Sibling]
- O86.1 — Other infection of genital tract following delivery [Sibling]
- and 13 more
Change history
- FY2019 — Added to the code set [Change history]
Referenced by Other Codes
Clinical classification (AHRQ CCSR):PRG023 — Complications specified during childbirth (default).
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Potential MS-DRG Relationships (FY2026)
Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.
Named in the grouper logic of 2 MS-DRGs: DRG 769 (MDC 14), DRG 776 (MDC 14).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Official ICD-10-CM tabular notes on other codes that name O86.00 or its code family.
9 Excludes1 notes: N70 (via O86.-), N70-N77 (via O86.-), N71 (via O86.-), N72 (via O86.-), N73 (via O86.-), N74 (via O86.-), N75 (via O86.-), N76 (via O86.-), N77 (via O86.-).
4 Excludes2 notes across 2 chapters: O75 (via O86.-), O75.4 (via O86.0.-), O98 (via O86.-), T81.4 (via O86.0.-).
Nearest Codes in This Family
Official ICD-10-CM classifications closest to O86.00 in its code family, with their registry titles.
- O86 — Other puerperal infections
- O86.0 — Infection of obstetric surgical wound
- O86.01 — Infection of obstetric surgical wound, superficial incisional site
- O86.02 — Infection of obstetric surgical wound, deep incisional site
- O86.03 — Infection of obstetric surgical wound, organ and space site
- O86.04 — Sepsis following an obstetrical procedure
- O86.09 — Infection of obstetric surgical wound, other surgical site
- O86.1 — Other infection of genital tract following delivery
- O86.11 — Cervicitis following delivery
- O86.12 — Endometritis following delivery
Indexed Clinical Terms (4)
Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code.
- Complication (s) (from) (of), cesarean delivery wound NEC, infection (following delivery)
- Complication (s) (from) (of), obstetric, surgical wound NEC, infection
- Infection, infected, infective (opportunistic), cesarean delivery wound (puerperal)
- Infection, infected, infective (opportunistic), obstetrical surgical wound (puerperal)