2024 ICD-10-CM Diagnosis Code O34.219

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

• Cesarean section following previous cesarean section
• Delivered by cesarean delivery following previous cesarean delivery
• Deliveries by cesarean
• Deliveries by cesarean
• Supervision of high risk pregnancy done
• Supervision of high risk pregnancy with history of previous cesarean section done
• Vaginal delivery
• Vaginal delivery following previous cesarean section

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

• 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).
• Diagnoses for females only - The Medicare Code Editor detects inconsistencies between a patient’s sex and any diagnosis on the patient’s record, these edits apply to FEMALES only .

O34.219 is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
817	OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC	14	2.255
818	OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC	14	1.1731
819	OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC	14	0.9072

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Replacement Code

O34219 replaces the following previously assigned ICD-10-CM code(s):

• O34.21 - Maternal care for scar from previous cesarean delivery

Convert O34.219 to ICD-9-CM

• ICD-9-CM Code: 654.21 - Prev c-delivery-delivrd
  Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.
• ICD-9-CM Code: 654.23 - Prev c-delivery-antepart
  Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education

Cesarean Delivery

What is a 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. Others are emergency cesarean deliveries, which are done when unexpected problems happen during delivery.

When is a cesarean delivery needed?

You may need a cesarean delivery because:

• You have health problems, including infection
• You are carrying more than one baby
• Your baby is too big
• Your baby is in the wrong position
• Your baby's health is in danger
• Labor is not moving along as it should
• There are problems with your placenta (the organ that brings oxygen and nutrients to your baby)

Not everyone who has had a cesarean delivery before will need another one next time. You may be able to have a vaginal birth after cesarean (VBAC). Talk to your health care provider about what is right for you.

How is a cesarean delivery done?

Before the surgery, you will be given pain medicine. Depending on your circumstances, you might get:

• An epidural block, which numbs the lower part of the body through an injection in the spine.
• A spinal block, which numbs the lower part of the body through an injection directly into the spinal fluid.
• General anesthesia, which makes you unconscious during the surgery. This is often used during emergency cesarean deliveries.

During the surgery, the surgeon will:

• Make a cut in your abdomen and uterus. The cut is usually horizontal, but in some cases it may be vertical.
• Open the amniotic sac and take out your baby.
• Cut the umbilical cord and the placenta.
• Close the uterus and abdomen with stitches that will later dissolve.

What are the risks of a cesarean delivery?

A cesarean delivery is relatively safe for you and your baby. But it is still a major surgery, and it carries risks. They may include:

• Infection
• Blood loss
• Blood clots in the legs, pelvic organs, or lungs
• Injury to surrounding structures, such as the bowel or bladder
• A reaction to the medicines or anesthesia used

Some of these risks do also apply to a vaginal birth. But it does take longer to recover from a cesarean delivery than from a vaginal birth. And having a cesarean delivery can raise the risk of having difficulties with future pregnancies. The more cesarean deliveries you have, the more the risk goes up.

NIH: National Institute of Child Health and Human Development

[Learn More in MedlinePlus]

Code History

• FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018