Ob-Gyn Coding Alert

Tip: Remember to include an additional code for the infectious agent.

Puerperal sepsis is known as childbed fever. Women can contract a bacterial infection during childbirth or a miscarriage. This is a serious form of septicemia and, if left untreated, is often fatal.

ICD-9-CM Codes: Currently, you should report this condition with the following ICD-9 codes:

• 670.22, Puerperal sepsis, delivered, with mention of postpartum complication
• 670.24, Puerperal sepsis, postpartum condition or complication

ICD-10-CM: However, when your diagnosis system changes, you should report instead:

• O85, Puerperal sepsis

ICD-10-CM Change: You will find that puerperal sepsis becomes simplified in ICD-10. You will have one code instead of two for postpartum puerperal sepsis.

Documentation: You should report O85 if your physician specifies “postpartum sepsis,” “puerperal peritonitis,” or “puerperal pyemia” in his documentation.

Check out the Excludes Notes for this code:

• Excludes1: fever of unknown origin following delivery (O86.4), genital tract infection following delivery (O86.1-), obstetric pyemic and septic embolism (O88.3-), puerperal septic thrombophlebitis (O86.81), urinary tract infection following delivery (O86.2-)

• Excludes2: sepsis during labor (O75.3)

Here is how you will find this code in the Alphabetic Index:

Abscess (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic) L02.91

-peritoneum, peritoneal (perforated) (ruptured) K65.1
--puerperal, postpartum, childbirth O85

Infection, infected, infective (opportunistic) B99.9

-major
-- puerperal, postpartum, childbirth O85
-- puerperal
--- major or generalized O85

MSSA (Methicillin susceptible Staphylococcus aureus)

- pelvic, puerperal, postpartum, childbirth O85
- puerperal, postpartum, childbirth (pelvic) O85
Pelviperitonitis - see also Peritonitis, pelvic
- puerperal O85

Peritonitis (adhesive) (bacterial) (fibrinous) (hemorrhagic) (idiopathic) (localized) (perforative) (primary) (with adhesions) (with effusion) K65.9

- puerperal, postpartum, childbirth O85

Puerperal, puerperium (complicated by, complications)

- metroperitonitis O85
- parametritis O85
- pelviperitonitis O85
- peritoneal infection O85
- peritonitis (pelvic) O85
- pyemia O85
- pyohemia O85
- salpingoperitonitis O85
- sepsis (pelvic) O85
- sepsis O85
- abscess
-- peritoneum O85
- fever (of unknown origin) O86.4
-- septic O85
- infection O86.4
-- generalized O85
-- peritoneum O85

Pyemia, pyemic (fever) (infection) (purulent) - see also Sepsis

- puerperal, postpartum, childbirth O85

Coder tips: You must use an additional code to identify infectious agent or the causal organism (e.g., for a bacterial infection, assign a code from category B95-B97, Bacterial infections in conditions classified elsewhere).

Also, if the patient has severe sepsis, you should use R65.2- as well. In addition, if she has any associated acute organ dysfunction, you should code that as well.

Do not use a code from category A40 (Streptococcal sepsis) or A41 (Other sepsis) for this condition.