The ICD-10 code range O60-O77 pertains to complications of labor and delivery. These codes are used to document various complications that may arise during the labor and delivery process, such as preterm labor, abnormality of forces of labor, and obstetric trauma. The codes within this range are highly specific, allowing for detailed documentation of the patient's condition and the complications encountered.

Key Usage Points:

•Always code to the highest level of specificity, using additional characters when available.
•Use multiple codes if more than one complication occurs during labor and delivery.
•Remember to code for any associated maternal care for damage to pelvic organs.
•Use additional codes from other chapters for associated conditions, if necessary.
•Always verify codes in the ICD-10-CM Tabular List of Diseases and Injuries.

Coding Guidelines

When to Use:

✓When a patient experiences preterm labor without delivery.
✓When a patient experiences complications from forceps or vacuum extractor usage.
✓When a patient suffers from obstetric trauma during delivery.
✓When a patient has complications due to breech delivery.
✓When a patient experiences complications from cesarean delivery.

When NOT to Use:

✗When the labor and delivery process is without complications.
✗When complications occur postpartum, not during labor or delivery.
✗When the patient's condition is not related to labor or delivery.
✗When the patient is not in the active phase of labor.
✗When the patient is in early or false labor.

Code Exclusions

Always verify exclusions in the ICD-10-CM Tabular List of Diseases and Injuries.

Documentation Requirements

Documentation for codes within the O60-O77 range should be comprehensive, detailing the specific complications encountered during labor and delivery. The type of complication, its cause, and any interventions or treatments provided should be clearly documented.

Clinical Information:

•Specific complication encountered during labor and delivery.
•Cause of the complication, if known.
•Any interventions or treatments provided.
•Outcome of the complication and impact on delivery.
•Any associated conditions or injuries.

Supporting Evidence:

•Labor and delivery records.
•Physician's notes detailing the complication and treatment.
•Operative reports for cesarean deliveries or other surgical interventions.
•Diagnostic reports confirming the complication.

Good Documentation Example:

Patient experienced preterm labor at 32 weeks. Tocolytic therapy was initiated and labor was successfully halted. No delivery occurred.

Poor Documentation Example:

Preterm labor.

Common Documentation Errors:

⚠Not coding to the highest level of specificity.
⚠Not using additional codes for associated conditions or injuries.
⚠Not documenting the cause of the complication.
⚠Not documenting any interventions or treatments provided.

Range Statistics

Total Codes

Billable

Complexity:

Medium

Primary Use:Clinical Documentation

Chapter:15

Coding Complexity

Medium

Complexity Rating

Coding within the O60-O77 range requires a solid understanding of the labor and delivery process and the various complications that can occur. Coders must be able to interpret detailed clinical information and apply the correct codes to accurately reflect the patient's condition and the care provided.

Key Factors:

▸The need to code to the highest level of specificity.
▸The need to use multiple codes for multiple complications.
▸The need to use additional codes for associated conditions or injuries.
▸The need to understand the clinical context of the labor and delivery process.
▸The need to keep up-to-date with changes and updates to the coding guidelines.

Specialty Focus

The O60-O77 range is primarily used by obstetricians and midwives, but may also be used by emergency medicine physicians and family practitioners who handle deliveries.

Primary Specialties:

Obstetrics and Gynecology

70%

Midwifery

20%

Family Practice

10%

Clinical Scenarios:

• A patient experiences preterm labor at 32 weeks, which is successfully halted with tocolytic therapy.
• A patient suffers a third-degree perineal laceration during a vaginal delivery.
• A patient has a retained placenta following delivery, requiring manual removal.
• A patient experiences a uterine rupture during a trial of labor after cesarean (TOLAC).
• A patient has a breech delivery, resulting in birth trauma to the infant.

Resources & References

Numerous resources are available to assist with coding within the O60-O77 range. These include the ICD-10-CM Official Guidelines for Coding and Reporting, coding manuals, and clinical references.

Official Guidelines:

ICD-10-CM Official Guidelines for Coding and Reporting
American Health Information Management Association (AHIMA) Coding Guidelines
Centers for Medicare & Medicaid Services (CMS) Coding Guidelines

Clinical References:

American College of Obstetricians and Gynecologists (ACOG) Practice Bulletins
World Health Organization (WHO) International Classification of Diseases (ICD)

Educational Materials:

AHIMA ICD-10-CM Coding Workbooks
AAPC ICD-10-CM Training Materials
WHO ICD-10 Training Manual

Frequently Asked Questions

Can I use multiple codes from the O60-O77 range for a single patient?

Yes, if a patient experiences multiple complications during labor and delivery, each should be coded separately. Always code to the highest level of specificity.