Excludes1 pair
O03.9 vs O22-
O03.9 and O22 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.
The official note, declared on O22
abortion NOS (O03.9)
O03.9
Complete or unspecified spontaneous abortion without complication
BillableUnspecified
- Chapter 15
- Pregnancy, childbirth and the puerperium
- Section
- O00-O08
Use when the record says
- Miscarriage NOS
- Spontaneous abortion NOS
Indexed under
- Abortion (complete) (spontaneous)
- Miscarriage
- Threatened › abortion › with subsequent abortion
O22
Venous complications and hemorrhoids in pregnancy
Not billable
- Chapter 15
- Pregnancy, childbirth and the puerperium
- Section
- O20-O29
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027