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ICD-10 Guide
ICD-10 CodesO34.63

O34.63

Billable

Maternal care for abnormality of vagina, third trimester

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

Code Description

ICD-10 O34.63 is a billable code used to indicate a diagnosis of maternal care for abnormality of vagina, third trimester.

Key Diagnostic Point:

O34.63 refers to maternal care for abnormalities of the vagina during the third trimester of pregnancy. This code is used when a pregnant woman presents with structural or functional abnormalities of the vagina that may impact her pregnancy or delivery. Such abnormalities can include congenital malformations, acquired conditions such as vaginal scarring from previous surgeries, or abnormalities related to pelvic organ dysfunction. These conditions may necessitate specialized care and monitoring to ensure the health of both the mother and the fetus. The presence of a previous cesarean section or uterine scarring can complicate the management of these abnormalities, as they may influence the mode of delivery and the risk of complications during childbirth. Careful assessment and documentation of the vaginal condition, along with any associated risks, are essential for appropriate coding and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in types of vaginal abnormalities requiring different management strategies.
  • Need for detailed documentation of previous obstetric history, including cesarean sections.
  • Potential for associated complications that may require additional coding.
  • Variability in clinical presentation and treatment plans based on individual patient factors.

Audit Risk Factors

  • Inadequate documentation of the specific vaginal abnormality.
  • Failure to document the impact of the abnormality on the pregnancy.
  • Misclassification of the type of abnormality leading to incorrect coding.
  • Lack of clarity regarding previous obstetric history, particularly cesarean sections.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of the vaginal abnormality, previous obstetric history, and any interventions performed.

Common Clinical Scenarios

Management of a patient with vaginal scarring from a previous surgery presenting for prenatal care.

Billing Considerations

Consideration of how the vaginal abnormality may affect delivery options and maternal-fetal health.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors associated with the vaginal abnormality and its implications for pregnancy.

Common Clinical Scenarios

Monitoring a high-risk pregnancy with a history of uterine scarring and vaginal abnormalities.

Billing Considerations

Focus on the potential for complications during labor and delivery, requiring a multidisciplinary approach.

Coding Guidelines

Inclusion Criteria

Use O34.63 When
  • According to official coding guidelines, O34
  • 63 should be used when there is a documented abnormality of the vagina in the third trimester that requires maternal care
  • Coders should ensure that the diagnosis is clearly linked to the care provided and that all relevant details are documented

Exclusion Criteria

Do NOT use O34.63 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 of a patient with vaginal abnormalities.

Documentation Requirements

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

Specialty Considerations

Obstetricians should ensure that all aspects of care are documented to support coding.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of vaginal abnormalities, improving the accuracy of maternal care documentation and reimbursement. Coders must be familiar with the nuances of these codes to ensure proper billing.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of vaginal abnormalities, improving the accuracy of maternal care documentation and reimbursement. Coders must be familiar with the nuances of these codes to ensure proper billing.

Reimbursement & Billing Impact

reimbursement. Coders must be familiar with the nuances of these codes to ensure proper billing.

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 types of vaginal abnormalities are covered under O34.63?

O34.63 covers a range of vaginal abnormalities including congenital malformations, acquired conditions such as scarring from previous surgeries, and other structural issues that may impact pregnancy and delivery.