Alphabetic Index FY2027

O85

Puerperal sepsis

FY2027Chapter 15: Pregnancy, childbirth and the puerperium/O85–O92 Complications predominantly related to the puerperium

BillableComplete code, valid to report
Care settingsHome Health Primary · MMTA - OtherHospital MCC

O85 is a billable ICD-10-CM diagnosis code for puerperal sepsis. It is part of the FY2027 code set, effective October 1, 2026. The Alphabetic Index lists it under 21 entries. Its coding notes include a Use additional code instruction, 4 Excludes1 entries and 10 Excludes2 entries.

Guidelines tips

From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.

The trimester character comes from the provider's documentation for the current encounter. The unspecified trimester code should rarely be used.

Guidelines I.C.15.a.3; I.C.15.a.5Pregnancy: the trimester characterRead the official text

O85 takes a secondary code for the organism. A40 and A41 are not used for puerperal sepsis, and O85 is not used for sepsis after an obstetrical procedure.

Guidelines I.C.15.kPuerperal sepsis (O85)Read the official text

Use additional code

Add the listed code as a secondary code, if known.

This code
  • code (B95-B97), to identify infectious agent
  • code (R65.2-) to identify severe sepsis, if applicable
Also from chapter/block level (1 note)
Inherited from Chapter 15 Pregnancy, childbirth and the puerperium
  • code, if applicable, from category Z3A, Weeks of gestation, to identify the specific week of the pregnancy, if known.

Excludes1

Not coded here. The listed conditions generally should not be reported together.

This code
  • fever of unknown origin following delivery (O86.4)
  • obstetric pyemic and septic embolism (O88.3-)
  • puerperal septic thrombophlebitis (O86.81)
Also from chapter/block level (1 note)
Inherited from Chapter 15 Pregnancy, childbirth and the puerperium
  • supervision of normal pregnancy (Z34.-)

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

This code
  • genital tract infection following delivery (O86.1-)
  • sepsis during labor (O75.3)
  • urinary tract infection following delivery (O86.2-)
Also from chapter/block level (7 notes)
Inherited from O85–O92 Complications predominantly related to the puerperium
  • mental and behavioral disorders associated with the puerperium (F53.-)
  • obstetrical tetanus (A34)
  • puerperal osteomalacia (M83.0)
Inherited from Chapter 15 Pregnancy, childbirth and the puerperium
  • mental and behavioral disorders associated with the puerperium (F53.-)
  • obstetrical tetanus (A34)
  • postpartum necrosis of pituitary gland (E23.0)
  • puerperal osteomalacia (M83.0)

Care settings

How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.

Home Health Primary

Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the MMTA - Other clinical group.

Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026

Hospital MCC

Counts as a major complication or comorbidity (MCC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 225 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.

Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix C

Inclusion terms

Conditions classified to this code.

This code
  • Postpartum sepsis
  • Puerperal peritonitis
  • Puerperal pyemia

Notes

Also from chapter/block level (6 notes)
Inherited from Chapter 15 Pregnancy, childbirth and the puerperium
  • CODES FROM THIS CHAPTER ARE FOR USE ONLY ON MATERNAL RECORDS, NEVER ON NEWBORN RECORDS
  • Codes from this chapter are for use for conditions related to or aggravated by the pregnancy, childbirth, or by the puerperium (maternal causes or obstetric causes)
  • Trimesters are counted from the first day of the last menstrual period. They are defined as follows:
    • 1st trimester- less than 14 weeks 0 days
    • 2nd trimester- 14 weeks 0 days to less than 28 weeks 0 days
    • 3rd trimester- 28 weeks 0 days until delivery

Alphabetic Index terms

Terms the official Alphabetic Index lists for this code. 21 entries

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