2026 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 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

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 2026 (October 1, 2025 through September 30, 2026) 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).

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Cesarean delivery, previous, affecting management of pregnancy
      • isthmocele (non-pregnant state)
        • maternal care for
    • Cesarean delivery, previous, affecting management of pregnancy
      • scar
        • defect (non-pregnant state)
          • maternal care for
    • Delivery(childbirth) (labor)
      • cesarean (for)
        • isthmocele
    • Delivery(childbirth) (labor)
      • cesarean (for)
        • previous
          • cesarean delivery
            • isthmocele
    • Delivery(childbirth) (labor)
      • cesarean (for)
        • previous
          • cesarean delivery
            • scar
              • defect (isthmocele)
    • Delivery(childbirth) (labor)
      • cesarean (for)
        • scar (s)
          • cesarean delivery
            • isthmocele
    • Delivery(childbirth) (labor)
      • cesarean (for)
        • scar (s)
          • cesarean delivery
            • scar
              • defect (isthmocele)
    • Delivery(childbirth) (labor)
      • cesarean (for)
        • scar (s)
          • defect (isthmocele)
    • Delivery(childbirth) (labor)
      • vaginal, following previous cesarean delivery
        • scar
          • defect (isthmocele)
    • Pregnancy(single) (uterine)
      • complicated by (care of) (management affected by)
        • cesarean scar defect (isthmocele)
    • Scar, scarring
      • defect (isthmocele)

Clinical ClassificationClinical

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

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

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 2022–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About O34.22Overview

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, 2025 through September 30, 2026.

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 817, 818, 819, 831, 832, 833, with relative weights from 0.5229 to 1.6880 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.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.