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ICD-10 Guide
ICD-10 CodesO34.211

O34.211

Billable

Maternal care for low transverse scar from previous cesarean delivery

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

Code Description

ICD-10 O34.211 is a billable code used to indicate a diagnosis of maternal care for low transverse scar from previous cesarean delivery.

Key Diagnostic Point:

O34.211 refers to the maternal care provided for women who have a low transverse 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 low transverse cesarean section is the most common surgical approach, characterized by a horizontal incision made in the lower segment of the uterus. Maternal care for this condition involves careful monitoring of the scar's integrity, assessing for potential complications such as uterine rupture, and planning for future deliveries. Healthcare providers must evaluate the patient's obstetric history, including the number of previous cesarean deliveries, the healing of the scar, and any associated complications. This code is crucial for ensuring that appropriate prenatal care is provided, including counseling on delivery options and the risks associated with vaginal birth after cesarean (VBAC). Proper documentation is essential to support the diagnosis and ensure comprehensive care throughout the pregnancy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for detailed obstetric history including previous cesarean deliveries
  • Assessment of uterine scar integrity and potential complications
  • Consideration of future delivery methods (VBAC vs repeat cesarean)
  • Documentation of maternal and fetal health status

Audit Risk Factors

  • Inadequate documentation of previous cesarean history
  • Failure to document maternal and fetal assessments
  • Misclassification of the type of cesarean scar
  • Lack of clear care plans for future deliveries

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include the patient's obstetric history, details of previous cesarean deliveries, and any complications encountered.

Common Clinical Scenarios

Patients with a history of cesarean delivery presenting for prenatal care, planning for VBAC, or experiencing complications related to the uterine scar.

Billing Considerations

Coders must ensure that the documentation supports the diagnosis and reflects the patient's current condition and care plan.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancy documentation must include detailed assessments of the uterine scar and any associated risks.

Common Clinical Scenarios

Management of pregnancies in women with multiple cesarean deliveries or those with complications related to uterine scarring.

Billing Considerations

High-risk scenarios require careful coding to reflect the complexity of care and potential interventions.

Coding Guidelines

Inclusion Criteria

Use O34.211 When
  • According to official coding guidelines, O34
  • 211 should be used when there is a documented history of a low transverse cesarean scar and the patient is receiving maternal care related to this condition
  • Coders must ensure that the diagnosis is supported by clinical documentation and that any associated complications are also coded appropriately

Exclusion Criteria

Do NOT use O34.211 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 in patients with a history of cesarean delivery.

Documentation Requirements

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

Specialty Considerations

Obstetricians must ensure that care plans reflect the patient's history of cesarean delivery.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including maternal care for low transverse scars. This specificity improves the accuracy of patient records and enhances the ability to track outcomes related to cesarean deliveries.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including maternal care for low transverse scars. This specificity improves the accuracy of patient records and enhances the ability to track outcomes related to cesarean deliveries.

Reimbursement & Billing Impact

reimbursement.

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 to support the use of O34.211?

Documentation should include the patient's history of cesarean deliveries, details of the low transverse scar, any complications experienced, and the care plan for the current pregnancy.