Coding Question of the Month

APRIL 2019: Coding for Obstetric Surgical Wounds

QUESTION:  What is the correct sequencing for obstetric surgical wounds and sepsis?

ANSWER:

For year 2019, code subcategory O86.0, Infection of Obstetric surgical wound, was expanded to identify the depth of the postprocedural infection. New codes are defined by the depth of postprocedural surgical site infection (SSI) as follows:

For superficial SSI, including subcutaneous abscess following a procedure and stitch abscess following the procedure, use code O86.01, Infection of obstetric surgical wound, superficial incisional site.

For deep SSI, including intramuscular abscess following a procedure and sub-fascial abscess following a procedure, assign code O86.02, Infection of obstetric surgical wound, deep incisional site.

For postprocedural infections that go into organ and space surgical sites, including intra-abdominal and subphrenic abscesses following an obstetrical procedure, apply code O86.03, Infection of obstetric surgical wound, organ and space site.

For sepsis following a procedure, use code O86.04.

Other new codes for this subcategory are O86.00, Infection of obstetric surgical wound, unspecified, and O86.09, Infection of obstetric surgical wound, other surgical site.

Sequencing SSIs and sepsis

According to 2019 ICD-10-CM Official Coding Guidelines 1.C.1.d.(5).(b), for patients with sepsis due to a obstetrical procedure a code from O86.00 to O86.03, Infection of obstetric surgical wound, should be coded first followed by a code O86.04, Sepsis following an obstetrical procedure.

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Donna Tyler
Director, Coding
DTyler@acog.org

Ipsita Salim
Coding Education Specialist
ISalim@acog.org

Miroslava Rudneva
Coding Education Specialist
MRudneva@acog.org

Tatyana Mallory
Facility Coding Education Specialist
TMallory@acog.org

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