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v1.0.0
ICD-10 Guide
ICD-10 CodesO34.218

O34.218

Billable

Maternal care for other type scar from previous cesarean delivery

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

Code Description

ICD-10 O34.218 is a billable code used to indicate a diagnosis of maternal care for other type scar from previous cesarean delivery.

Key Diagnostic Point:

O34.218 refers to maternal care for women who have a scar from a previous cesarean delivery that is not classified as a classical or low transverse scar. This code is essential for documenting the care of pregnant women who may have complications related to their uterine scarring, which can affect labor and delivery outcomes. The presence of a scar can lead to concerns about uterine rupture, abnormal placentation, and other complications during pregnancy and childbirth. Proper management of these patients requires careful monitoring and may involve specialized care from obstetricians and maternal-fetal medicine specialists. The clinical approach includes assessing the type of scar, evaluating the risk factors associated with the previous cesarean, and planning for delivery to ensure the safety of both the mother and the fetus. This code is crucial for ensuring that healthcare providers are compensated for the additional care and monitoring required for these patients.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of scar types and their implications for delivery
  • Need for detailed documentation of previous cesarean history
  • Potential for complications requiring multidisciplinary care
  • Variability in clinical management based on scar characteristics

Audit Risk Factors

  • Inadequate documentation of previous cesarean details
  • Failure to specify the type of scar
  • Misclassification of scar type leading to incorrect coding
  • Lack of evidence for increased monitoring or care

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include details of the previous cesarean delivery, type of scar, and any complications experienced during the current pregnancy.

Common Clinical Scenarios

Patients with a history of multiple cesarean deliveries, those presenting with abnormal placentation, or those experiencing complications related to uterine scarring.

Billing Considerations

Coders should ensure that all relevant clinical details are captured to support the complexity of care provided.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancy documentation must include comprehensive assessments of the scar, potential risks, and management plans.

Common Clinical Scenarios

Patients with a history of uterine rupture or abnormal placentation requiring specialized monitoring.

Billing Considerations

High-risk scenarios necessitate thorough documentation to justify the level of care and interventions provided.

Coding Guidelines

Inclusion Criteria

Use O34.218 When
  • According to the official ICD
  • CM guidelines, coders should ensure that the code is used in conjunction with other relevant codes that describe the patient's current pregnancy and any complications
  • Documentation must support the need for this specific code, particularly in cases where the type of scar may influence management

Exclusion Criteria

Do NOT use O34.218 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 indications for cesarean delivery and details of the patient's obstetric history.

Specialty Considerations

Obstetricians should document the type of scar and any complications that arise during the procedure.

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, including those related to previous cesarean deliveries. This specificity helps in better tracking of maternal health outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of maternal conditions, including those related to previous cesarean deliveries. This specificity helps in better tracking of maternal health outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of maternal conditions, including those related to previous cesarean deliveries. This specificity helps in better tracking of maternal health outcomes and resource allocation.

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 O34.218?

Coding O34.218 is significant as it captures the complexities associated with maternal care for women with scars from previous cesarean deliveries. Accurate coding ensures appropriate management and monitoring of potential complications, which is crucial for maternal and fetal safety.