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v1.0.0
ICD-10 Guide
ICD-10 CodesO34.212

O34.212

Billable

Maternal care for vertical scar from previous cesarean delivery

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

Code Description

ICD-10 O34.212 is a billable code used to indicate a diagnosis of maternal care for vertical scar from previous cesarean delivery.

Key Diagnostic Point:

O34.212 refers to maternal care for women who have a vertical scar from a previous cesarean delivery. This condition is significant as it indicates a history of surgical intervention in the uterus, which can impact future pregnancies and deliveries. The presence of a vertical scar may lead to complications such as uterine rupture, abnormal placentation, and increased risk during labor. Careful monitoring and management are essential to ensure maternal and fetal safety. Healthcare providers must assess the integrity of the scar, evaluate the risk of complications, and provide appropriate counseling regarding delivery options. This code is crucial for tracking maternal health outcomes and ensuring that women receive the necessary care tailored to their obstetric history.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of previous surgical history and its implications.
  • Involves assessment of potential complications related to uterine scarring.
  • Documentation must clearly indicate the type of cesarean scar.
  • May require coordination with maternal-fetal medicine specialists.

Audit Risk Factors

  • Inadequate documentation of the surgical history.
  • Failure to note complications arising from the scar.
  • Misclassification of the type of cesarean scar.
  • Lack of clear communication between providers regarding care plans.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include details of the previous cesarean delivery, type of incision, and any complications experienced.

Common Clinical Scenarios

A patient with a vertical scar presenting for prenatal care, requiring assessment of delivery options.

Billing Considerations

Consideration of the risks associated with vaginal delivery after cesarean (VBAC) and the need for a multidisciplinary approach.

Maternal-Fetal Medicine

Documentation Requirements

Detailed records of maternal and fetal assessments, including ultrasound findings related to the scar.

Common Clinical Scenarios

Management of a high-risk pregnancy with a history of vertical cesarean scar.

Billing Considerations

Involvement of specialists for monitoring and planning delivery to mitigate risks.

Coding Guidelines

Inclusion Criteria

Use O34.212 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the code is used in conjunction with other relevant codes that reflect the patient's complete obstetric history and current condition

Exclusion Criteria

Do NOT use O34.212 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 a patient with a vertical cesarean scar.

Documentation Requirements

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

Specialty Considerations

Obstetricians should ensure that all aspects of care are documented to support billing.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of maternal conditions, improving the ability to track outcomes and complications related to previous cesarean deliveries.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of maternal conditions, improving the ability to track outcomes and complications related to previous cesarean deliveries.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of maternal conditions, improving the ability to track outcomes and complications related to previous cesarean deliveries.

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 O34.212?

Coding O34.212 is crucial for identifying patients with a history of cesarean delivery and monitoring potential complications in future pregnancies. It helps healthcare providers tailor care plans and ensures appropriate management of risks associated with uterine scarring.