Fact Sheet: Abortion Complications and Related ICD-10 Codes

Many women present to the emergency department following abortion. The risk of an emergency department (ED) visit is especially pronounced for drug-induced abortions,^[1] with the Food and Drug Administration label for the abortion drug mifepristone acknowledging that 2.9% to 4.6% of women who use mifepristone may end up in the ED.^[2] Research shows that ED visits following the use of abortion drugs are more likely to be complex and severe than visits following surgical abortion or live birth or among women who are not pregnant.^[3] Historically, many women who experienced a complication from abortion drugs did not return to the abortion center, instead relying on emergency departments and other providers for care.^[4] Now that abortion drugs are available via the mail, many women may live hundreds of miles from the abortionist who sent them the drugs, making it very likely that any complications will be treated by other providers, including an ED. Furthermore, even though abortion drugs will not resolve an ectopic pregnancy and risks increase with advancing gestation, many women using these drugs are not screened for ectopic pregnancy or gestational age, meaning that they may present to the ED with these complications.^[5]

Despite these risks, research shows that a high majority (84%) of abortion-drug-related ED visits are miscoded, and these miscoded visits are more likely to be severe and complex.^[6] Not only does this miscoding potentially undermine the care women receive, it also results in an undercount of complications associated with abortion drugs, which may explain the low ED rates in published research based on ED data alone.^[7] For these reasons, CLI has compiled this list of ICD-10 codes associated with abortion drug complications as a resource for emergency physicians and other ED clinicians as well as recommendations for future coding updates.

Listed below are the currently available ICD-10 codes for abortion complications. There are thirteen general categories of complications following successful termination of pregnancy (ending the embryonic/fetal life) and fourteen general categories of complications following failed attempted termination of pregnancy.

O04.5:  Genital tract and pelvic infection following (induced) termination of pregnancy

O04.6:  Delayed or excessive hemorrhage following (induced) termination of pregnancy

O04.7:  Embolism following (induced) termination of pregnancy

O04.80:  (Induced) termination of pregnancy with unspecified complications

O04.81:  Shock following (induced) termination of pregnancy

O04.82:  Renal failure following (induced) termination of pregnancy

O04.83:  Metabolic disorder following (induced) termination of pregnancy

O04.84:  Damage to pelvic organs following (induced) termination of pregnancy

O04.85:  Other venous complications following (induced) termination of pregnancy

O04.86:  Cardiac arrest following (induced) termination of pregnancy

O04.87:  Sepsis following (induced) termination of pregnancy

O04.88:  Urinary tract infection following (induced) termination of pregnancy

O04.89:  (Induced) termination of pregnancy with other complications

The following codes are used less commonly because they indicate the abortion procedure has not been successful in ending the life of the embryo or fetus. Although they are sometimes misused to indicate the abortion procedure has been unsuccessful in extruding all the pregnancy tissue, this is an inaccurate use of the code because abortion is defined as an action having the “intent to end the unborn life.” Successful death of the embryo/fetus but retained pregnancy tissue should be coded with a different complication code, but unfortunately this specific code does not exist.

O07.0:  Genital tract and pelvic infection following failed attempted termination of pregnancy

O07.1:  Delayed or excessive hemorrhage following failed attempted termination of pregnancy

O07.2:  Embolism following failed attempted termination of pregnancy

O07.30:  Failed attempted termination of pregnancy with unspecified complications

O07.31:  Shock following failed attempted termination of pregnancy

O07.32:  Renal failure following failed attempted termination of pregnancy

O07.33:  Metabolic disorder following failed attempted termination of pregnancy

O07.34:  Damage to pelvic organs following failed attempted termination of pregnancy

O07.35:  Other venous complications following failed attempted termination of pregnancy

O07.36:  Cardiac arrest following failed attempted termination of pregnancy

O07.37:  Sepsis following failed attempted termination of pregnancy

O07.38:  Urinary tract infection following failed attempted termination of pregnancy

O07.39:  Failed attempted termination of pregnancy with other complications

O07.4:  Failed attempted termination of pregnancy without complication

For complications which do not already have a specific abortion ICD-10 code, the following codes should be used in combination with general, non-abortion codes for each specific complication:

O04.80:  (Induced) termination of pregnancy with unspecified complications

O04.89:  (Induced) termination of pregnancy with other complications

O07.30:  Failed attempted termination of pregnancy with unspecified complications

O07.39:  Failed attempted termination of pregnancy with other complications

Abortion provided without first diagnosing an ectopic pregnancy should be coded with the appropriate code from the following list (along with an induced abortion code as above):

O00.0:  abdominal pregnancy

O00.1:  tubal pregnancy

O00.2:  ovarian pregnancy

O00.8:  other ectopic pregnancy

O00.9:  ectopic pregnancy, unspecified

In a doctor’s medical judgment or if specified by the patient, a mental health complication caused by induced abortion may be coded with one of the following codes (along with an induced abortion code):

F10.1:  alcohol abuse

F11.1:  opioid abuse

F12.1:  Cannabis abuse

F13.1:  sedative, hypnotic or anxiolytic-related abuse

F14.1:  cocaine abuse

F15.1:  other stimulant abuse

F30:  manic episode

F31:  Bipolar episode

F32:  depressive episode

F41:  other anxiety disorders

Similarly, other complications that do not currently contain a code in the induced abortion list should be coded with both the code for the complication and an induced abortion code. For example, if a pulmonary complication occurred, the appropriate respiratory code would be chosen along with an induced abortion code. Additionally, a post-surgical complication should be coded with the code indicating “other postprocedural complications and disorders of genitourinary system” (N99.89) along with an induced abortion code. For example, if hemorrhage were the complication, O04.6 “Delayed or excessive hemorrhage following (induced) termination of pregnancy” should be added to N99.89.

Proposed codes for future updates to the ICD-10 coding manual

Because the existing ICD-10 codes related to abortion complications are limited and do not include all potential complications that may result from induced abortion we recommend that additional ICD-10 codes be created. This could include:

• Creating a separate category for complications following medication abortion.
• Creating a separate category for complications following surgical abortion.
• The coding of damage to pelvic organs could be further delineated to indicate which organ was damaged, including vagina, cervix, uterus, adnexa, urinary tract, gastrointestinal tract, or vascular system.
• Codes for the following complications added to each of the broader categories:
  • Retained pregnancy tissue
  • Undiagnosed ectopic pregnancy
  • Pulmonary complications (pneumonia, ARDS, mechanical ventilation)
  • Transfusion
  • Complication requiring primary surgery (after medication abortion): suction aspiration, laceration repair, laparotomy, hysterectomy, bowel resection
  • Complication requiring repeat surgery (after surgical abortion): suction aspiration, laceration repair, laparotomy, hysterectomy, bowel resection
  • Mental health complications: depression, anxiety, substance abuse, alcohol abuse, self-harm, post-traumatic stress disorder
• Death codes related to complications of termination of pregnancy:
  • Death from suicide after termination of pregnancy
  • Death from procedural complications
  • Death from complications of medication abortion
  • Death from other causes after termination of pregnancy
• Classify hemorrhage complications by quantifying amount of hemorrhage.
• Require the addition of the gestational age modifier, which is already in use for pregnancy-related diagnosis codes.
• Complications following selective reductions of multiple gestations should also be coded as induced abortion complications.

[1] Upadhyay UD, Desai S, Zlidar V, et al. Incidence of emergency department visits and complications after abortion. Obstet Gynecol. 2015;125(1):175-183. doi:10.1097/AOG.0000000000000603

[2] https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/020687s020lbl.pdf

[3] Studnicki J, Fisher JW, Cox TL, et al. Comparative Acuity of Emergency Department Visits Following Pregnancy Outcomes Among Medicaid Eligible Women, 2004-2015. Int J Epidemiol Public Health Res. 2024;5(2). doi:10.61148/2836-2810/IJEPHR/075

[4] Aultman K, Cirucci CA, Harrison DJ, Beran BD, Lockwood MD, Seiler S. Deaths and Severe Adverse Events after the use of Mifepristone as an Abortifacient from September 2000 to February 2019. Issues Law Med. 2021;36(1):3-26.

[5] Skop I. Chemical Abortion: Risks Posed by Changes in Supervision. Journal of American Physicians and Surgeons. 2022;27(2):56-61. https://www.jpands.org/vol27no2/skop.pdf

[6] Studnicki J, Fisher JW, Cox TL, et al. Determining the Period Prevalence and Acuity of Emergency Department Visits Following Induced Abortion Mistakenly Identified as Spontaneous Abortion: An Analytic Observational Prospective Cohort Study. J Family Med Prim Care Open Acc. 2025;9:282. doi:10.29011/2688-7460.100282

[7] Upadhyay UD, Johns NE, Barron R, et al. Abortion-related emergency department visits in the United States: An analysis of a national emergency department sample. BMC Med. 2018;16(1):88. Published 2018 Jun 14. doi:10.1186/s12916-018-1072-0