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ICD-10 Guide
ICD-10 CodesO34.3

O34.3

Billable

Maternal care for cervical incompetence

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

Code Description

ICD-10 O34.3 is a billable code used to indicate a diagnosis of maternal care for cervical incompetence.

Key Diagnostic Point:

Cervical incompetence, also known as cervical insufficiency, is a condition where the cervix begins to dilate and efface prematurely during pregnancy, often leading to preterm birth or pregnancy loss. This condition is typically diagnosed in women with a history of cervical surgery, trauma, or congenital anomalies affecting the cervix. Maternal care for cervical incompetence involves close monitoring and may include interventions such as cervical cerclage, which is a surgical procedure to stitch the cervix closed to prevent premature delivery. Women with a history of cervical incompetence may also have other pelvic organ abnormalities or previous cesarean deliveries that complicate their obstetric history. Proper management requires a multidisciplinary approach, including obstetricians and maternal-fetal medicine specialists, to ensure the best outcomes for both the mother and the fetus.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for detailed patient history regarding previous pregnancies and cervical surgeries.
  • Differentiation between cervical incompetence and other causes of preterm labor.
  • Documentation of maternal and fetal monitoring protocols.
  • Potential for multiple interventions and their coding implications.

Audit Risk Factors

  • Inadequate documentation of the patient's obstetric history.
  • Failure to specify the type of cervical intervention performed.
  • Misclassification of cervical incompetence with other obstetric conditions.
  • Lack of follow-up documentation post-intervention.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of cervical assessments, interventions, and outcomes is essential. This includes ultrasound findings, physical exam notes, and any surgical reports related to cervical procedures.

Common Clinical Scenarios

Common scenarios include a patient with a history of cervical surgery presenting with signs of cervical incompetence or a patient undergoing cervical cerclage due to previous preterm births.

Billing Considerations

Coders must be aware of the nuances in coding for patients with multiple risk factors, including previous cesarean sections and pelvic organ abnormalities.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancy documentation must include detailed assessments of maternal and fetal well-being, including regular ultrasounds and monitoring for signs of preterm labor.

Common Clinical Scenarios

Complex maternal-fetal scenarios may involve patients with a history of multiple losses due to cervical incompetence or those requiring advanced interventions.

Billing Considerations

High-risk coding requires careful attention to detail and understanding of the implications of cervical incompetence on overall pregnancy management.

Coding Guidelines

Inclusion Criteria

Use O34.3 When
  • According to official obstetric coding guidelines, O34
  • 3 should be used when there is clear documentation of cervical incompetence and its management
  • Coders should ensure that all relevant clinical information is captured to support the diagnosis and any associated procedures

Exclusion Criteria

Do NOT use O34.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59300CPT Code

Cervical cerclage

Clinical Scenario

Used in cases of cervical incompetence to prevent preterm birth.

Documentation Requirements

Documentation must include indications for the procedure, patient history, and post-operative care.

Specialty Considerations

Obstetricians must ensure that the procedure is well-documented to support the coding.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of cervical incompetence, improving the accuracy of data collection and reimbursement processes. It has also enhanced the ability to track outcomes related to this condition more effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cervical incompetence, improving the accuracy of data collection and reimbursement processes. It has also enhanced the ability to track outcomes related to this condition more effectively.

Reimbursement & Billing Impact

reimbursement processes. It has also enhanced the ability to track outcomes related to this condition more effectively.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What is the significance of coding O34.3 accurately?

Accurate coding of O34.3 is crucial for ensuring appropriate reimbursement and for tracking maternal and fetal outcomes related to cervical incompetence. It also helps in identifying patients who may require specialized care and monitoring.