ICD-10 Diagnosis Code O32.9XX9

• 652.61 - Mult gest malpres-deliv (Approximate Flag)
• 652.91 - Malposition NOS-deliver (Approximate Flag)
• 652.93 - Malposition NOS-antepart (Approximate Flag)

• Multiple gestation with one OR more fetal malpresentations
• Multiple pregnancy with malpresentation
• Multiple pregnancy with malpresentation with antenatal problem

While childbirth usually goes well, complications can happen. They can cause a risk to the mother, baby, or both. Possible complications include

• Preterm (premature) labor, when labor starts before 37 completed weeks of pregnancy
• Problems with the umbilical cord
• Problems with the position of the baby, such as breech, in which the baby is going to come out feet first
• Birth injuries

For some of these problems, the baby may need to be delivered surgically by a Cesarean section.

• Assisted delivery with forceps (Medical Encyclopedia)
• Brachial plexus injury in newborns (Medical Encyclopedia)
• Breech birth (Medical Encyclopedia)
• Caput succedaneum (Medical Encyclopedia)
• Meconium aspiration syndrome (Medical Encyclopedia)
• Premature rupture of membranes (Medical Encyclopedia)

If you are pregnant with more than one baby, you are far from alone. Multiple births are up in the United States. More women are having babies after age 30 and more are taking fertility drugs. Both boost the chance of carrying more than one baby. A family history of twins also makes multiples more likely.

Years ago, most twins came as a surprise. Now, most women know about a multiple pregnancy early. Women with multiple pregnancies should see their health care providers more often than women who are expecting one baby. Multiple pregnancy babies have a much higher risk of being born prematurely and having a low birth weight. There is also more of a risk of disabilities. Some women have to go on bed rest to delay labor. Finally, they may deliver by C-section, especially if there are three babies or more.

Parenting multiples can be a challenge. Volunteer help and support groups for parents of multiples can help.

Dept. of Health and Human Services Office on Women's Health

General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

• Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
• No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
• Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.

Present on Admission
The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement.