ICD-10 Coding for Cesarean Delivery(O82, O34.21)
Complete ICD-10-CM coding and documentation guide for Cesarean Delivery. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Cesarean Delivery
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| O82 | Encounter for cesarean delivery without indication | Use when a cesarean is performed solely at the patient's request without any medical indication. |
|
| O34.21 | Maternal care for scar from previous cesarean delivery | Use when a cesarean is planned due to a previous cesarean scar. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for elective cesarean delivery
Essential facts and insights about Cesarean Delivery
Primary ICD-10-CM Codes for cesarean delivery
Decision Criteria
documentation Criteria
- Patient's request for cesarean without medical indication
Applicable To
- Elective cesarean delivery without medical necessity
Excludes
- Cesarean delivery with medical indication
Clinical Validation Requirements
- Patient request documented
- No medical indication for cesarean
Code-Specific Risks
- Potential audit if medical necessity is not clearly documented
Coding Notes
- Ensure patient consent and request are documented.
O34.21 - Maternal care for scar from previous cesarean delivery
Use when a cesarean is planned due to a previous cesarean scar.
Applicable To
- Planned repeat cesarean
Excludes
- Emergency cesarean due to complications
Clinical Validation Requirements
- Previous cesarean scar documented
- Ultrasound confirming scar location
Coding Notes
Ensure previous cesarean history is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Single live birth
Z37.0Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Cesarean Delivery to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O82.
Impact
Clinical: Incomplete documentation of delivery outcome., Regulatory: Non-compliance with coding guidelines., Financial: Potential claim denials due to incomplete coding.
Mitigation Strategy
Always review delivery documentation for completeness., Use checklists to ensure all required codes are included.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding standards., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Use 59610 for VBAC instead of 59400.
Impact
Risk of audit if elective cesarean is not properly documented.
Mitigation Strategy
Ensure thorough documentation of patient request and consent.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Cesarean Delivery, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Cesarean Delivery
Use these documentation templates to ensure complete and accurate documentation for Cesarean Delivery. These templates include all required elements for proper coding and billing.
Elective Cesarean Delivery
Specialty: ObstetricsRequired Elements
- Patient request
- No medical indication
- Outcome of delivery
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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