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v1.0.0
ICD-10 Guide
ICD-10 CodesO34.21

O34.21

Billable

Maternal care for scar from previous cesarean delivery

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/08/2025

Code Description

ICD-10 O34.21 is a billable code used to indicate a diagnosis of maternal care for scar from previous cesarean delivery.

Key Diagnostic Point:

Maternal care for scar from a previous cesarean delivery refers to the ongoing management and monitoring of women who have a history of cesarean section. This condition is significant as it involves the assessment of the uterine scar's integrity and the potential risks associated with subsequent pregnancies. Women with a cesarean scar may face complications such as uterine rupture, abnormal placentation, and increased risk of hemorrhage during labor. Careful evaluation of the pelvic organs is essential, as scarring can lead to abnormalities that may affect future pregnancies. Healthcare providers must ensure that the patient is informed about the risks and benefits of vaginal birth after cesarean (VBAC) versus repeat cesarean delivery. Regular ultrasounds may be indicated to assess the scar's healing and the overall health of the uterus. This code is crucial for documenting maternal care in the context of previous surgical interventions and ensuring appropriate follow-up and management strategies are in place.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for detailed patient history regarding previous cesarean deliveries.
  • Assessment of uterine scar integrity and potential complications.
  • Differentiation between normal and abnormal pelvic organ conditions.
  • Documentation of patient counseling regarding delivery options.

Audit Risk Factors

  • Inadequate documentation of the patient's surgical history.
  • Failure to document counseling regarding delivery options.
  • Misclassification of the type of delivery planned (VBAC vs. repeat cesarean).
  • Lack of follow-up notes on the status of the uterine scar.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include detailed history of previous cesarean deliveries, current pregnancy status, and any complications.

Common Clinical Scenarios

Patients with a history of cesarean delivery seeking care for a subsequent pregnancy, evaluation of uterine scar integrity, and counseling for VBAC.

Billing Considerations

Consideration of the patient's preferences and medical history when discussing delivery options.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancy documentation must include assessments of uterine scar, maternal health, and fetal well-being.

Common Clinical Scenarios

Management of high-risk pregnancies with previous cesarean deliveries, monitoring for complications, and planning for delivery.

Billing Considerations

Involvement of multidisciplinary teams for comprehensive care and risk assessment.

Coding Guidelines

Inclusion Criteria

Use O34.21 When
  • According to ICD
  • 10 coding guidelines, O34
  • 21 should be used when there is a documented history of cesarean delivery and ongoing maternal care related to the scar
  • It is essential to ensure that the code is supported by clinical documentation reflecting the patient's history and current management plan

Exclusion Criteria

Do NOT use O34.21 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59400CPT Code

Obstetrical care including antepartum care, delivery, and postpartum care

Clinical Scenario

Used for comprehensive obstetric care for patients with a history of cesarean delivery.

Documentation Requirements

Complete documentation of all prenatal visits, delivery, and postpartum follow-up.

Specialty Considerations

Obstetricians must ensure thorough documentation to support the coding of comprehensive care.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of maternal care related to previous cesarean deliveries, improving the accuracy of patient records and facilitating better care management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of maternal care related to previous cesarean deliveries, improving the accuracy of patient records and facilitating better care management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of maternal care related to previous cesarean deliveries, improving the accuracy of patient records and facilitating better care management.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of coding O34.21?

Coding O34.21 is crucial for accurately documenting maternal care related to previous cesarean deliveries, which can impact management decisions and patient outcomes in subsequent pregnancies.