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v1.0.0
ICD-10 Guide
ICD-10 CodesO34.219

O34.219

Billable

Maternal care for unspecified type scar from previous cesarean delivery

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

Code Description

ICD-10 O34.219 is a billable code used to indicate a diagnosis of maternal care for unspecified type scar from previous cesarean delivery.

Key Diagnostic Point:

O34.219 refers to maternal care for women who have a scar from a previous cesarean delivery, where the specific type of scar is not specified. This condition is significant in obstetric care as it can impact future pregnancies and deliveries. Women with a history of cesarean delivery may experience complications such as uterine rupture, abnormal placentation, or issues related to the integrity of the pelvic organs. The presence of a scar can also influence decisions regarding the mode of delivery in subsequent pregnancies, necessitating careful monitoring and management. Healthcare providers must assess the scar's characteristics, the patient's obstetric history, and any associated risks to ensure optimal maternal and fetal outcomes. Proper documentation of the scar's status and any related complications is crucial for accurate coding and billing.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in scar types and their implications for future pregnancies
  • Need for detailed patient history to assess risks
  • Potential for complications that require additional coding
  • Documentation requirements for different types of care settings

Audit Risk Factors

  • Inadequate documentation of the type of cesarean scar
  • Failure to note complications related to the scar
  • Misclassification of the scar type leading to incorrect coding
  • Lack of follow-up documentation for subsequent pregnancies

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation should include details of the previous cesarean delivery, the type of scar, and any complications experienced.

Common Clinical Scenarios

Patients with a history of cesarean delivery presenting for prenatal care, planning for VBAC (vaginal birth after cesarean), or experiencing complications.

Billing Considerations

Consideration of the patient's obstetric history, including the number of previous cesareans and any complications that may affect future deliveries.

Maternal-Fetal Medicine

Documentation Requirements

Detailed documentation of maternal and fetal health, including risk assessments related to the cesarean scar.

Common Clinical Scenarios

High-risk pregnancies where the patient has a history of multiple cesarean deliveries or complications related to uterine scarring.

Billing Considerations

Focus on monitoring for potential complications such as uterine rupture or abnormal placentation.

Coding Guidelines

Inclusion Criteria

Use O34.219 When
  • Follow the official ICD
  • CM guidelines for obstetric coding, ensuring that all relevant details about the patient's history and current condition are documented
  • Specific criteria for coding maternal care must be adhered to, including the need for specificity in the type of scar

Exclusion Criteria

Do NOT use O34.219 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59510CPT Code

Cesarean delivery

Clinical Scenario

Used when a cesarean delivery is performed due to complications from a previous cesarean scar.

Documentation Requirements

Documentation must include the indication for cesarean delivery and details of the previous cesarean.

Specialty Considerations

Obstetricians must ensure that the risks associated with the previous cesarean are clearly documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding maternal care for cesarean scars, improving the ability to track complications and outcomes associated with previous cesarean deliveries.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding maternal care for cesarean scars, improving the ability to track complications and outcomes associated with previous cesarean deliveries.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding maternal care for cesarean scars, improving the ability to track complications and outcomes associated with 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 should be documented for O34.219?

Documentation should include the patient's history of cesarean delivery, the type of scar if known, any complications experienced, and the current pregnancy status to ensure accurate coding.