Quick answer: In ICD-10-CM, pregnancy loss and termination are coded in Chapter 15 with categories such as O03 (spontaneous abortion), O02.1 (missed abortion) and O04 (complications following termination of pregnancy), and an uncomplicated elective termination is reported with Z33.2. Procedures are reported with CPT codes 59812 to 59857 or, for medication abortion, HCPCS S codes where payers accept them. Older references that cite codes 634 to 636 are ICD-9 codes and must not be used.
ICD-10-CM Diagnosis Codes
| Code | Description |
| O02.1 | Missed abortion (early fetal death with retention of the products of conception) |
| O03.4 | Incomplete spontaneous abortion without complication |
| O03.9 | Complete or unspecified spontaneous abortion without complication |
| O03.0 to O03.3 | Incomplete spontaneous abortion with complications, such as infection, hemorrhage or embolism |
| O03.5 to O03.89 | Complete or unspecified spontaneous abortion with complications |
| O04.5 to O04.89 | Complications following (induced) termination of pregnancy |
| O07.- | Failed attempted termination of pregnancy |
| Z33.2 | Encounter for elective termination of pregnancy |
| Z3A.- | Weeks of gestation, when applicable |
Ectopic pregnancy is coded in O00.-, and molar pregnancy in O01.-. Follow the ICD-10-CM Official Guidelines in Section I.C.15.q for pregnancy with abortive outcome.
CPT and HCPCS Procedure Codes
| Code | Description |
| 59812 | Treatment of incomplete abortion, any trimester, completed surgically |
| 59820 | Treatment of missed abortion, completed surgically; first trimester |
| 59821 | Treatment of missed abortion, completed surgically; second trimester |
| 59830 | Treatment of septic abortion, completed surgically |
| 59840 | Induced abortion, by dilation and curettage |
| 59841 | Induced abortion, by dilation and evacuation |
| 59850 to 59857 | Induced abortion by intra-amniotic injection or vaginal suppository, with or without additional procedures |
| S0199 | Medically induced abortion by oral ingestion of medication, including all associated services and supplies (accepted by some payers) |
Codes 58120 (non-obstetrical dilation and curettage) and 59160 (postpartum curettage) do not describe abortion procedures and should not be used for them.
Payer and Compliance Considerations
- Coverage rules for pregnancy termination vary widely by payer and by state. Verify coverage and any required documentation before billing.
- Federal Medicaid funding is limited by law to specific circumstances, and some state Medicaid programs require modifiers or forms (for example, HCPCS modifier G7) to identify qualifying cases. Follow your state Medicaid manual.
- Document the gestational age, method, medications and any complications so the correct diagnosis, procedure and Z3A codes can be assigned.
- Protect patient privacy carefully, as this is sensitive health information.
Frequently Asked Questions
What is the ICD-10 code for a miscarriage?
Spontaneous abortion is coded in category O03, by whether it is incomplete or complete and whether there are complications. For example, O03.9 is complete or unspecified spontaneous abortion without complication.
What is the ICD-10 code for a missed abortion?
O02.1.
Are codes 634 to 636 valid?
No. Those are ICD-9-CM codes, which were replaced by ICD-10-CM on October 1, 2015.
How is surgical treatment of a missed abortion coded?
Use 59820 for the first trimester or 59821 for the second trimester.
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