ICD code O07.0 – Pelvic infection after failed termination

Key takeaways

O07.0 applies only when a termination was attempted and failed, and a genital tract or pelvic infection followed, with all three documented.

The tabular list includes endometritis, oophoritis, parametritis, pelvic peritonitis, salpingitis and salpingo-oophoritis following a failed attempted termination.

A urinary tract infection (O07.38) or sepsis (O07.37) after a failed termination takes its own code, and both are Excludes1 at O07.0.

When sepsis is documented, assign O07.37 first instead of O07.0, with an additional code for the specific infection or organism.

ICD-10 code O07.0: code details at a glance

ICD-10 code O07.0 is the billable code for genital tract and pelvic infection following failed attempted termination of pregnancy. It sits in the O00-O08 block (pregnancy with abortive outcome) within Chapter 15 of ICD-10-CM. The table below summarizes the reference fields coders need before claim submission.

What O07.0 covers: included infection types

O07.0 codes a genital tract or pelvic infection that follows a failed attempted termination. The infection must follow a documented termination attempt that did not achieve its intended result. Infection after a spontaneous abortion, or after a completed induced termination, uses a different code.

The ICD-10-CM tabular list includes the following infection types under O07.0, each following a failed attempted termination:

• Endometritis – infection of the uterine lining
• Oophoritis – infection of one or both ovaries
• Parametritis – infection of the parametrium, the connective tissue next to the uterus
• Pelvic peritonitis – infection of the peritoneum lining the pelvic cavity
• Salpingitis – infection of the fallopian tubes
• Salpingo-oophoritis – infection involving both the fallopian tubes and the ovaries

Two infections that often get grouped with these take their own codes. A urinary tract infection after a failed attempted termination is O07.38, and sepsis is O07.37. Both are Excludes1 notes at O07.0.

The clinical record must document the causal relationship between the failed procedure and the infection. A pelvic infection that predates the procedure can’t support O07.0. Neither can one where the provider doesn’t clearly state the link to the failed attempt.

Includes and Excludes1 notes for O07.0

Check the official Includes and Excludes1 notes before assigning O07.0. They decide which neighboring codes can and can’t appear on the same claim.

The Excludes1 note at the O07 parent level prohibits reporting O07.x together with O03.0-. Spontaneous and failed-attempt scenarios are coded separately, so the record must be clear on which occurred before any O07 subcode is assigned. At O07.0 itself, the Excludes1 notes send sepsis to O07.37 and urinary tract infection to O07.38.

O07.0 within the O07 code family

O07.0 is one of five subcodes under parent O07. Each subcode covers a distinct complication type following a failed attempted termination. Selecting the correct subcode requires the provider’s documentation to specify the complication present.

When a patient presents with both infection and hemorrhage after a failed termination attempt, code both O07.0 and O07.1. The O07 family does not prohibit multiple subcode assignment when distinct complications coexist, provided each is documented.

How O07.0 differs from closely related codes

O03.x, O04.x and O07.1 each share surface-level clinical similarities with O07.0. The underlying clinical scenario determines which code applies.

Hemorrhage after a failed attempt is coded separately from the infection. The guide to O07.1 covers the bleeding side of the same scenario, including when both codes appear on one claim.

Put together, the choice comes down to three questions about the record, in a fixed order:

Clinical scenario: when to assign ICD-10 code O07.0

ICD-10 code O07.0 needs the four elements below documented before it can be assigned. Missing any one leaves the code unsupported.

1. Termination procedure attempted. The clinical record confirms a medical or procedural termination of pregnancy was initiated (medication administered or surgical procedure performed).
2. Procedure failed. The provider documents that the procedure did not achieve the intended result. The pregnancy continued, or products of conception were not fully expelled.
3. Infection develops postprocedure. A genital tract or pelvic infection is diagnosed in the period following the failed attempt, and the provider links it to the procedure.
4. Infection type specified. The provider identifies the infection as endometritis, oophoritis, parametritis, pelvic peritonitis, salpingitis or salpingo-oophoritis.

The organism isn’t one of the required elements. If one is identified (for example, Group B Streptococcus or E. coli), add a code for it from categories B95-B97.

Sometimes the record shows only that infection followed a pregnancy-related procedure, without confirming the procedure failed. The correct code is then more likely O04.x or O03.x. Coders must not infer a failed attempt from clinical context alone.

Sequencing rules and when sepsis changes the code

Under the ICD-10-CM Official Guidelines for Coding and Reporting, O07.0 is the principal diagnosis when no sepsis is present. That holds when a genital tract or pelvic infection is the reason for the encounter after a confirmed failed termination.

When sepsis is documented, O07.0 no longer applies. Sepsis following a failed attempted termination has its own Chapter 15 code, O07.37, and O07.0 carries an Excludes1 note for it. Chapter 15 guidelines give that code sequencing priority, so the claim is built like this:

1. O07.37 (sepsis following failed attempted termination of pregnancy), sequenced first in place of O07.0
2. An additional code for the specific infection or causative organism
3. R65.2- if severe sepsis is documented, plus codes for any organ dysfunction (for example, N17.9 for acute kidney injury)

O07.0 applies only to a genital tract or pelvic infection without sepsis. Check the current guidelines each year on the CMS ICD-10 codes page, as Chapter 15 guidelines receive periodic updates.

Documentation requirements and payer considerations for O07.0

Accurate O07.0 assignment depends on four documentation elements. Payers, including Medicaid programs, can audit obstetric complication codes for medical necessity and coding specificity. Intake and procedure forms that prompt for each element make them easier to capture at the point of care.

• Operative or procedure note – confirms the termination was attempted and documents the method (medical or surgical)
• Failure documentation – provider attestation that the procedure did not achieve termination (for example, continued intrauterine pregnancy on follow-up ultrasound)
• Infection diagnosis – postprocedure documentation identifying the specific infection type
• Provider linkage statement – explicit statement linking the infection to the failed procedure, since coders cannot create this link from inference

On the billing side, O07.0 maps to CMS MS-DRG groupings under the obstetric complication DRGs for inpatient encounters. For professional (outpatient) claims, the code is submitted on the CMS-1500 form as the primary or additional diagnosis, based on the encounter reason. Payer policies on termination-related codes vary, so check the payer’s local coverage determinations (LCDs) and national coverage determinations (NCDs).

A clean claim submission for an O07.0 encounter pairs the diagnosis with the correct procedure code. That means ICD-10-PCS for inpatient claims and CPT for outpatient claims. Confirm the code combination doesn’t trigger a Correct Coding Initiative (CCI) edit before it goes out.

Coding and documentation errors that put O07.0 claims at risk

Five coding and documentation errors leave an O07.0 claim open to denial or audit.

• Wrong parent code family. Assigning O07.0 when the procedure succeeded (use O04.x) or when the abortion was spontaneous (use O03.x). The claim then describes an event the record doesn’t support.
• Missing procedure documentation. The claim cannot be substantiated without an operative note or provider statement confirming a termination was attempted. Assigning O07.0 from a discharge summary alone, without an underlying procedure note, exposes the claim to audit reversal.
• Infection as secondary when it is the principal reason for encounter. When a patient presents specifically for management of a postprocedural pelvic infection, O07.0 must be the principal diagnosis. Listing it as a secondary code misstates the reason for the encounter.
• Coding O07.0 with sepsis. Sepsis following a failed attempted termination is O07.37, which is Excludes1 with O07.0.
• Mutually exclusive code pairing. Assigning O07.x together with O03.0- (incomplete spontaneous abortion) violates the Excludes1 note at the O07 parent level. Both cannot appear on the same claim.

Structured denial management workflows tag each O07.x denial by root cause. That shows whether the fix is better documentation, coder education or a payer policy query. The AAPC ICD-10-CM code lookup and the CDC/NCHS ICD-10-CM web tool are free references for current descriptors and tabular notes.

For the neighboring codes in this chapter and beyond, browse our diagnostic code guides before you finalize the claim.

How Pabau supports O07.0 claim submission and tracking

Without a connected billing system, a rejected O07.0 claim sends someone hunting for the operative note, the follow-up note and the original submission by hand. That search can take longer than the correction itself.

Pabau, the practice management platform we build, keeps the patient record and the claim in one place. Its trackable claims management shows where each claim sits, from submission to payment. Pabau’s integration with the Claim.MD clearinghouse supports electronic claim submission and tracking for US practices, using the diagnosis codes your team assigns.

You can also build Pabau’s digital forms to prompt for the four documentation elements above. The coder then works from a complete record, instead of sending a query days after the visit.

Submit and track O07.0 claims in one place

Pabau’s Claim.MD integration supports electronic claim submission and tracking for US practices, using the diagnosis codes your team assigns. See how it fits your billing workflow.

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Conclusion

Treat O07.0 as a narrow code. It holds up only when the chart proves three facts: a failed attempt, a postprocedural infection and the provider’s link between them. If sepsis or a urinary tract infection is documented, the claim belongs to O07.37 or O07.38 instead.

The trade-off is time up front. A coding query before submission costs less than reworking a denied claim weeks later.

Pabau keeps your medical billing workflows and patient records together, and its Claim.MD integration handles electronic submission and tracking for US practices. Book a demo to see how Pabau keeps your O07.0 documentation and claims in one place.

Continue your research

Coding bleeding after the same failed attempt? ICD-10 code O07.1 covers delayed or excessive hemorrhage after a failed attempted termination, and when it pairs with O07.0.

Was the termination completed instead? ICD-10 code O04.6 shows how the O04 family handles complications after a completed induced termination.

Encountering denials on O07.x claims? Denial management in healthcare outlines root-cause categorization and remediation strategies for systematic claim denials.

Submitting claims through a US clearinghouse? Claim.MD clearinghouse overview explains how clearinghouse submission works with ICD-10-CM diagnosis codes on professional and facility claims.

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