ICD-10-CM Diagnosis Code O04.5 - Genital tract and pelvic infection following (induced) termination of pregnancy (original) (raw)

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ICD List 2025-2026 Edition

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Genital tract and pelvic infection following (induced) termination of pregnancy

ICD-10-CM Code:

O04.5

ICD-10 Code for:

Genitl trct and pelvic infct fol (induced) term of pregnancy

Is Billable?

Yes - Valid for Submission

Chronic Condition Indicator: [1]

Not chronic

Code Navigator:

O04.5 is a billable diagnosis code used to specify a medical diagnosis of genital tract and pelvic infection following (induced) termination of pregnancy. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2025 through September 30, 2026.

The code O04.5 is applicable to female patients aged 12 through 55 years inclusive. It is clinically and virtually impossible to use this code on a non-female patient outside the stated age range.

  1. Code Information
  2. Approximate Synonyms
  3. Clinical Classification
  4. Clinical Information
  5. Tabular List of Diseases and Injuries
  6. Index to Diseases and Injuries References
  8. Code Edits
  9. Convert to ICD-9 Code
  10. Patient Education
  11. Other Codes Used Similar Conditions
  12. Code History

The following list of clinical terms are approximate synonyms, alternative descriptions, or common phrases that might be used by patients, healthcare providers, or medical coders to describe the same condition. These synonyms and related diagnosis terms are often used when searching for an ICD-10 code, especially when the exact medical terminology is unclear. Whether you're looking for lay terms, similar diagnosis names, or common language alternatives, this list can help guide you to the correct ICD-10 classification.

Clinical Classifications group individual ICD-10-CM diagnosis codes into broader, clinically meaningful categories. These categories help simplify complex data by organizing related conditions under common clinical themes.

They are especially useful for data analysis, reporting, and clinical decision-making. Even when diagnosis codes differ, similar conditions can be grouped together based on their clinical relevance. Each category is assigned a unique CCSR code that represents a specific clinical concept, often tied to a body system or medical specialty.

CCSR Code: PRG004

Inpatient Default: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.

Outpatient Default: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

inflammation of the parametrium, the connective tissue of the pelvic floor, extending from the subserous coat of the uterus laterally between the layers of the broad ligament.

a broad fold of peritoneum that extends from the side of the uterus to the wall of the pelvis.

inflammation of the peritoneum surrounding the pelvic organs.

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

References found for this diagnosis code in the External Cause of Injuries Index:

The Medicare Code Editor (MCE) detects errors and inconsistencies in ICD-10-CM diagnosis coding that can affect Medicare claim validity. These Medicare code edits help medical coders and billing professionals determine when a diagnosis code is not appropriate as a principal diagnosis, does not meet coverage criteria. Use this list to verify whether a code is valid for Medicare billing and to avoid claim rejections or denials due to diagnosis coding issues.

The Medicare Code Editor detects inconsistencies in maternity cases by checking a patient's age and any diagnosis on the patient's record. The maternity code edits apply to patients age ange is 9–64 years inclusive (e.g., diabetes in pregnancy, antepartum pulmonary complication).

Below are the ICD-9 codes that most closely match this ICD-10 code, based on the General Equivalence Mappings (GEMs). This ICD-10 to ICD-9 crosswalk tool is helpful for coders who need to reference legacy diagnosis codes for audits, historical claims, or approximate code comparisons.

ICD-9-CM: 635.02

Approximate Flag - The approximate mapping means this ICD-10 code does not have an exact ICD-9 equivalent. The matched code is the closest available option, but it may not fully capture the original diagnosis or clinical intent.

Abortion

An induced abortion is a procedure to end a pregnancy. It can be done two different ways:

An induced abortion is different from a spontaneous abortion. That is the loss of a pregnancy before the 20th week of pregnancy. It is more commonly known as a miscarriage.

If you are thinking of having an induced abortion, talk with your health care provider. Your provider can explain how the procedures are done, as well as the risks and benefits of each.

[Learn More in MedlinePlus]