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ICD-10-CM 2027 diagnosis code

O86.04Sepsis following an obstetrical procedure

✓ Billable / specificMCC — major complication/comorbidityMaternity · age 9–64Female only

O86.04 is a valid, billable ICD-10-CM code for sepsis following an obstetrical procedure. It can be reported on claims for dates of service from October 1, 2026 – September 30, 2027.

Code last changed in FY2019 (effective October 1, 2018). Source: official FY2027 ICD-10-CM release from CDC/NCHS and CMS. Page updated September 29, 2026. About our data

About O86.04

O86.04 is the ICD-10-CM diagnosis code for sepsis following an obstetrical procedure. It belongs to category O86 (other puerperal infections), block O85-O92 (complications predominantly related to the puerperium) and chapter 15 (pregnancy, childbirth and the puerperium). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Within O86.0 (infection of obstetric surgical wound), O86.04 is specifically for sepsis following an obstetrical procedure. Related codes cover unspecified (O86.00), superficial incisional site (O86.01), deep incisional site (O86.02), organ and space site (O86.03) and other surgical site (O86.09).

Use an additional code to identify the sepsis: code (B95-B97), to identify infectious agent.

As a secondary diagnosis it is an MCC (major complication or comorbidity), which can move an inpatient stay into the highest-paying "with MCC" MS-DRG of its family, unless the principal diagnosis excludes it.

In MS-DRG v44.0, it is part of the grouping logic for DRG 769 (Postpartum and Post Abortion Diagnoses with O.R. Procedures, relative weight 1.6673) and DRG 776 (Postpartum and Post Abortion Diagnoses without O.R. Procedures, relative weight 0.6721), in MDC 14 (Pregnancy, Childbirth and the Puerperium), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

The Medicare Code Editor treats this as a maternity diagnosis, expected only for patients age 9 through 64.

It is on the CMS list of diagnoses consistent only with female patients (the sex-conflict edit itself was retired in FY2025).

It was added in FY2019, effective October 1, 2018.

Coding notes

Use additional codeAdd a secondary code to fully describe the condition
  • code to identify the sepsis

Notes that apply from higher levels

Instructions written at a parent level also apply to O86.04.

› From O86.0 Infection of obstetric surgical wound
Excludes1
  • complications of procedures, not elsewhere classified (T81.4-)
  • postprocedural fever NOS (R50.82)
  • postprocedural retroperitoneal abscess (K68.11)
› From O86 Other puerperal infections
Excludes2
  • infection during labor (O75.3)
  • obstetrical tetanus (A34)
Use additional code
  • code (B95-B97), to identify infectious agent

Broader instructions also apply from O85-O92 Complications predominantly related to the puerperium and Chapter 15: Pregnancy, childbirth and the puerperium.

Alphabetic index entries

1 entries

Terms in the official ICD-10-CM index that lead to O86.04.

MS-DRG v44.0 grouping

All DRGs →

Inpatient MS-DRGs this diagnosis can group to, as the principal or a secondary diagnosis, depending on the rest of the claim.

MDC 14 · Pregnancy, Childbirth and the Puerperium

MDC 14 · Pregnancy, Childbirth and the Puerperium

Code history

  1. 2016
  2. 2017
  3. 2018
  4. 2019
  5. 2020
  6. 2021
  7. 2022
  8. 2023
  9. 2024
  10. 2025
  11. 2026
  12. 2027
  • FY2019 (effective 10/1/2018): Added
  • No changes since FY2019.

Common questions about O86.04

Is O86.04 billable?

Yes. O86.04 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).

Can O86.04 be used as a principal diagnosis?

Yes. The Medicare Code Editor doesn't restrict O86.04 as a principal diagnosis.

Is O86.04 a CC or MCC?

O86.04 is an MCC (major complication or comorbidity) under MS-DRG v44.0, unless excluded by the principal diagnosis.

What DRG does O86.04 group to?

O86.04 is used in the MS-DRG v44.0 logic for MS-DRG 769 (Postpartum and Post Abortion Diagnoses with O.R. Procedures) and MS-DRG 776 (Postpartum and Post Abortion Diagnoses without O.R. Procedures). Which one applies depends on whether it is the principal diagnosis and on the rest of the claim.