ICD-10 O03.9
Billable / SpecificComplete or unspecified spontaneous abortion without complication
About ICD-10-CM O03.9
ICD-10-CM code O03.9 represents Complete or unspecified spontaneous abortion without complication. This is a billable/specific code in the Pregnancy, Childbirth, and Puerperium chapter (block O03). The 2026 edition of ICD-10-CM O03.9 became effective on October 1, 2025.
Coding Tips for O03.9
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
Most O codes require a 7th character indicating trimester (1 = first, 2 = second, 3 = third). Some require fetus identification character. Code O09 (supervision of high-risk pregnancy) is required as a secondary code when applicable.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under O03.9. Per CMS ICD-10-CM Tabular 2026.
- Miscarriage NOS
- Spontaneous abortion NOS
Medicare LCD Coverage for O03.9
Local Coverage Determinations (LCDs) from CMS MACs that list O03.9 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing O03.9.
1 Cigna
1 Aetna
CPT Codes Commonly Billed with O03.9
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 76801 OB ultrasound first trimester — pregnancy supervision, high-risk pregnancy, abnormal prenatal screening, prenatal screening, spontaneous abortion OB/GYN
Convert O03.9 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| O03.9 | 63490 | 10000 |
| O03.9 | 63492 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To O03.9
Other codes in section O00-O08 (Pregnancy with abortive outcome).
ICD-10 O03.9, Billing FAQ
Is ICD-10 code O03.9 billable? +
Yes, O03.9 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to O03.9? +
ICD-10 O03.9 includes: Miscarriage NOS; Spontaneous abortion NOS.
What CPT codes are commonly billed with O03.9? +
Procedures frequently paired with O03.9 include: 76801.
What ICD-9 codes does O03.9 map to? +
Per CMS GEMs, O03.9 maps to ICD-9 codes: 63490, 63492. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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