ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesO34.22

O34.22

Billable

Maternal care for cesarean scar defect (isthmocele)

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

Code Description

ICD-10 O34.22 is a billable code used to indicate a diagnosis of maternal care for cesarean scar defect (isthmocele).

Key Diagnostic Point:

O34.22 refers to maternal care for a cesarean scar defect, commonly known as isthmocele. This condition arises when a defect occurs at the site of a previous cesarean section, leading to the formation of a pouch or sac in the uterine wall. This defect can result in various complications, including abnormal bleeding, pain, and potential infertility. The clinical management of isthmocele often requires careful monitoring and may involve surgical intervention, particularly if the patient experiences significant symptoms or complications during subsequent pregnancies. It is crucial for healthcare providers to document the patient's obstetric history, including the number of cesarean deliveries and any associated symptoms, to ensure appropriate coding and care planning. The condition may also impact future pregnancies, necessitating a multidisciplinary approach to maternal care, especially in high-risk populations.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires detailed documentation of previous cesarean deliveries.
  • Involves understanding of pelvic organ abnormalities.
  • May require coordination with multiple specialties for management.
  • Potential for overlapping symptoms with other gynecological conditions.

Audit Risk Factors

  • Inadequate documentation of previous cesarean sections.
  • Failure to note associated symptoms such as pain or abnormal bleeding.
  • Misclassification of isthmocele as a different pelvic condition.
  • Lack of follow-up documentation for ongoing maternal care.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include the patient's obstetric history, details of previous cesarean deliveries, and any current symptoms related to isthmocele.

Common Clinical Scenarios

Patients presenting with pelvic pain, abnormal uterine bleeding, or infertility following a cesarean delivery.

Billing Considerations

Consideration of the patient's overall reproductive health and potential need for surgical intervention.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancy documentation must include detailed assessments of maternal and fetal health, particularly in cases of uterine scarring.

Common Clinical Scenarios

Management of pregnancies complicated by isthmocele, especially in patients with a history of multiple cesarean sections.

Billing Considerations

Close monitoring of maternal-fetal outcomes and potential interventions during pregnancy.

Coding Guidelines

Inclusion Criteria

Use O34.22 When
  • According to official obstetric coding guidelines, O34
  • 22 should be used when there is clear documentation of a cesarean scar defect, with emphasis on the patient's obstetric history and current symptoms
  • Coders should ensure that all relevant details are captured to support the diagnosis

Exclusion Criteria

Do NOT use O34.22 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

58661CPT Code

Laparoscopy, surgical, with fulguration of endometriosis

Clinical Scenario

Used when isthmocele is associated with endometriosis requiring surgical intervention.

Documentation Requirements

Detailed operative notes and pre-operative assessments.

Specialty Considerations

Obstetricians should collaborate with gynecologists for 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 conditions like isthmocele, improving the accuracy of maternal care documentation and facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like isthmocele, improving the accuracy of maternal care documentation and facilitating better patient management.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    ACOG Practice Bulletin on Cesarean Delivery

Coding & Billing References

  • •
    ACOG Practice Bulletin on Cesarean Delivery

Frequently Asked Questions

What is isthmocele and how does it affect pregnancy?

Isthmoceles are defects in the uterine wall resulting from previous cesarean sections. They can lead to complications such as abnormal bleeding and pain, which may affect future pregnancies and require careful monitoring and management.