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ICD-10 Guide
ICD-10 CodesChapter 15: Pregnancy, childbirth and the puerperiumO82

O82

Billable

Encounter for cesarean delivery without indication

Chapter 15:Pregnancy, childbirth and the puerperium

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 O82 is a billable code used to indicate a diagnosis of encounter for cesarean delivery without indication.

Key Diagnostic Point:

The ICD-10 code O82 is designated for encounters involving cesarean deliveries that occur without any specific medical indication. This category encompasses situations where a cesarean section is performed as a planned procedure, often due to patient preference or other non-medical reasons. It is crucial to differentiate these encounters from those that involve medical necessity, as this impacts clinical decision-making and resource allocation within healthcare settings. Understanding the nuances of this code helps healthcare providers document the circumstances surrounding the delivery accurately and ensures appropriate coding for billing purposes.

  • Clinically, the significance of O82 lies in its ability to capture data on cesarean deliveries that are not necessitated by complications or health risks. This information is vital for analyzing trends in delivery methods, patient choices, and the overall safety and efficacy of cesarean sections. Usage guidelines suggest that O82 should be applied when a cesarean delivery is planned and executed without any indications such as fetal distress, maternal health issues, or other complications that typically warrant surgical intervention. Accurate coding in this category supports quality measures and helps healthcare organizations assess their practices regarding cesarean deliveries.

Code Complexity Analysis

Complexity Rating: Low

Low Complexity

Complexity Factors

  • Clear documentation requirements
  • Limited clinical scenarios
  • Straightforward coding guidelines

Audit Risk Factors

  • Potential for overuse of cesarean deliveries
  • Documentation discrepancies
  • Misclassification of delivery type

Specialty Focus

Medical Specialties

Obstetrics

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Gynecology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical impact of the O82 code category is significant, as it provides insights into the prevalence of cesarean deliveries performed without medical indications. This data can inform healthcare policies and practices aimed at reducing unnecessary surgical interventions, thereby improving patient safety and outcomes. Additionally, tracking cesarean delivery trends can help healthcare organizations identify areas for improvement in prenatal care and patient education regarding delivery options.
From an administrative perspective, accurate coding under O82 contributes to quality measures and population health management initiatives. It allows healthcare systems to analyze the implications of cesarean delivery rates on maternal and neonatal health outcomes. Furthermore, understanding the factors leading to non-indicated cesarean deliveries can guide healthcare providers in developing strategies to address patient preferences and improve shared decision-making processes, ultimately enhancing the quality of care provided to expectant mothers.

ICD-9 vs ICD-10

The clinical impact of the O82 code category is significant, as it provides insights into the prevalence of cesarean deliveries performed without medical indications. This data can inform healthcare policies and practices aimed at reducing unnecessary surgical interventions, thereby improving patient safety and outcomes. Additionally, tracking cesarean delivery trends can help healthcare organizations identify areas for improvement in prenatal care and patient education regarding delivery options. From an administrative perspective, accurate coding under O82 contributes to quality measures and population health management initiatives. It allows healthcare systems to analyze the implications of cesarean delivery rates on maternal and neonatal health outcomes. Furthermore, understanding the factors leading to non-indicated cesarean deliveries can guide healthcare providers in developing strategies to address patient preferences and improve shared decision-making processes, ultimately enhancing the quality of care provided to expectant mothers.

Reimbursement & Billing Impact

reimbursement. Providers must ensure that the medical records reflect the absence of indications for the cesarean delivery, as this is crucial for justifying the use of the O82 code. Additionally, it is important to be aware of payer-specific guidelines, as some insurers may have different requirements for cesarean deliveries without indications. Proper coding can facilitate smoother claims processing and reduce the likelihood of denials or audits.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for O82

Coding & Billing References

  • •
    Official ICD-10 Guidelines for O82

Frequently Asked Questions

What conditions are included in O82?

O82 includes encounters for cesarean deliveries that are performed without any medical indications, meaning there are no complications or health issues necessitating the surgical procedure.

When should I use O82 codes?

O82 codes should be used when documenting a planned cesarean delivery that is not based on medical necessity, such as patient preference or other non-clinical factors.

What documentation is required for O82?

Documentation for O82 should clearly indicate that the cesarean delivery was performed without any medical indications, including notes on patient discussions and consent regarding the choice of delivery method.