2027 ICD-10-CM Diagnosis Code O34.22Maternal care for cesarean scar defect (isthmocele)

ICD-10-CM Codes›O00-O9A›O30-O48›O34

ICD-10-CM O34.22
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

O34.22 is a billable ICD-10-CM diagnosis code for maternal care for cesarean scar defect (isthmocele). It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 817 through 819, 831 through 833. The code is restricted by the Medicare Code Editor to maternity cases (age 9 through 64). In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Previous C-section.

Code Identity

ICD-10-CM Code
O34.22
Billable Status
Yes — Valid for Submission
Code Describes
Maternal care for cesarean scar defect (isthmocele)
Short Description
Maternal care for cesarean scar defect (isthmocele)
Same as the full description in the CMS dataset.
Parent Code
O34.2
Maternal care due to uterine scar from previous surgery

Code Classification

ChapterO00-O9APregnancy, childbirth and the puerperium
SectionO30-O48Maternal care related to the fetus and amniotic cavity and possible delivery problems
CategoryO34Maternal care for abnormality of pelvic organs
This CodeO34.22Maternal care for cesarean scar defect (isthmocele)

Code EditsBilling

Medicare Code Editor checks that affect claim validity for O34.22.

Maternity diagnoses
The Medicare Code Editor detects inconsistencies in maternity cases by checking a patient's age and any diagnosis on the patient's record. The maternity code edits apply to patients age ange is 9–64 years inclusive (e.g., diabetes in pregnancy, antepartum pulmonary complication).

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to O34.22: its own notes plus those printed at O34 and Chapter 15. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From O34 Maternal care for abnormality of pelvic organs applies to 54 codes
  • the listed conditions as a reason for hospitalization or other obstetric care of the mother, or for cesarean delivery before onset of labor

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From Chapter 15 (O00-O9A) Pregnancy, childbirth and the puerperium applies to 2,481 codes
  • supervision of normal pregnancy (Z34.-)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Chapter 15 (O00-O9A) Pregnancy, childbirth and the puerperium applies to 2,481 codes
  • mental and behavioral disorders associated with the puerperium (F53.-)
  • obstetrical tetanus (A34)
  • postpartum necrosis of pituitary gland (E23.0)
  • puerperal osteomalacia (M83.0)

Code First

The underlying condition named in the note is sequenced before this code.

From O34 Maternal care for abnormality of pelvic organs applies to 54 codes
  • any associated obstructed labor (O65.5)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From O34 Maternal care for abnormality of pelvic organs applies to 54 codes
  • code for specific condition
From Chapter 15 (O00-O9A) Pregnancy, childbirth and the puerperium applies to 2,481 codes
  • code, if applicable, from category Z3A, Weeks of gestation, to identify the specific week of the pregnancy, if known.

Notes

General instructions on how these codes are used.

From Chapter 15 (O00-O9A) Pregnancy, childbirth and the puerperium applies to 2,481 codes
  • CODES FROM THIS CHAPTER ARE FOR USE ONLY ON MATERNAL RECORDS, NEVER ON NEWBORN RECORDS
  • Codes from this chapter are for use for conditions related to or aggravated by the pregnancy, childbirth, or by the puerperium (maternal causes or obstetric causes)
  • Trimesters are counted from the first day of the last menstrual period. They are defined as follows:
  • 1st trimester- less than 14 weeks 0 days
  • 2nd trimester- 14 weeks 0 days to less than 28 weeks 0 days
  • 3rd trimester- 28 weeks 0 days until delivery

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name O34.22, its category, or a range that includes it.

Applicable To 1

These notes mention O34.22.

  • O65.5 Obstructed labor due to abnormality of maternal pelvic organs
    Obstructed labor due to conditions listed in O34.- names O34.-, which includes this code

Excludes1 2

These codes carry an Excludes1 note naming O34.22: they are not reported together with it, unless the two conditions are unrelated.

  • N85.A Isthmocele
    maternal care for cesarean scar defect (isthmocele) (O34.22)
  • Z98.891 History of uterine scar from previous surgery
    Maternal care due to uterine scar from previous surgery (O34.2-) names O34.2-, which includes this code

Excludes2 1

These codes carry an Excludes2 note naming O34.22: its condition is not part of those codes, and both may be reported when the patient has both.

  • O99.8 Other specified diseases and conditions complicating pregnancy, childbirth and the puerperium
    maternal care for known or suspected abnormality of maternal pelvic organs (O34.-) names O34.-, which includes this code

Use Additional Code 1

These codes say to use an additional code from the note, and O34.22 is one of the codes named.

  • O65.5 Obstructed labor due to abnormality of maternal pelvic organs
    code to identify abnormality of pelvic organs O34.- names O34.-, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR PRG016
Previous C-section
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Cesarean Delivery

A cesarean delivery, also called a cesarean section or c-section, is surgery to deliver a baby. The baby is taken out through your abdomen (belly). In the United States, almost one in three babies are born this way. Some cesarean deliveries are planned.

The full article covers:

  • What is a cesarean delivery?
  • When is a cesarean delivery needed?
  • How is a cesarean delivery done?
  • What are the risks of a cesarean delivery?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Code History & ChangesHistory

Replacement O34.22 replaces the following previously assigned code(s):

  • O34.219 - Maternal care for unsp type scar from previous cesarean del
FY 2021AddedAdded to the ICD-10-CM code setEffective October 1, 2020.
FY 2022–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About O34.22Overview

What is the ICD-10 code for maternal care for cesarean scar defect (isthmocele)?

The ICD-10-CM code for maternal care for cesarean scar defect (isthmocele) is O34.22 (sometimes written as O3422). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is O34.22 (Maternal care due to uterine scar from previous surgery) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report maternal care for cesarean scar defect (isthmocele) on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does O34.22 group to?

When maternal care for cesarean scar defect (isthmocele) is the principal diagnosis on an inpatient stay, it groups to MS-DRG 833, 832, 831, 819, 818, 817, with relative weights from 0.5000 to 1.7586 depending on complications. Higher weights mean higher Medicare reimbursement.

Who can O34.22 be reported for?

The Medicare Code Editor checks maternal care for cesarean scar defect (isthmocele) against patient demographics: this code is intended for maternity cases (age 9 through 64). Claims outside these limits are flagged as inconsistent.

Does O34.22 need an additional code?

When the condition applies, yes. The Use Additional Code note at O34, which applies to O34.22, reads: code for specific condition. The additional code is reported after O34.22.