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O34.219 ICD-10-CM Code: Maternal care for unspecified type scar from previous cesarean delivery

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 817 — OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC (MDC 14)
  • MS-DRG 818 — OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC (MDC 14)
  • MS-DRG 819 — OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC (MDC 14)
  • MS-DRG 831 — OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC (MDC 14)
  • MS-DRG 832 — OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC (MDC 14)
  • MS-DRG 833 — OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC (MDC 14)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Official Registry Overview & Definition

Maternal care for unspecified type scar from previous cesarean delivery is a billable ICD-10-CM diagnosis code (O34.219).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for O34.219 in the official ICD-10-CM tabular list.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • the listed conditions as a reason for hospitalization or other obstetric care of the mother, or for cesarean delivery before onset of labor

Code First

Underlying conditions that must be sequenced before this code.

  • any associated obstructed labor (O65.5)

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code for specific condition

Change history

  • FY2017 — 2016-10-01
    Added to the code set
    Maternal care for unspecified type scar from previous cesarean delivery
    FY2017 changes

Verify Before Coding

  • Age-restricted: the Medicare Code Editor lists this as a maternity (age 9-64) diagnosis; other ages are presumed incorrect.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Contextual Map

Every relationship of O34.219 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

  • O00-O9A — Chapter 15: Pregnancy, Childbirth and the Puerperium (O00-O9A) (O00-O9A) [Hierarchy]
  • O30-O48 — Maternal care related to the fetus and amniotic cavity and possible delivery problems [Hierarchy]
  • O34 — Clinical Diagnosis [Hierarchy]
  • O34.2 — Clinical Diagnosis [Hierarchy]
  • O34.21 — Clinical Diagnosis [Hierarchy]

Referenced by Excludes1 notes

  • Z98.891 — History of uterine scar from previous surgery [Excludes1](via O34.2.-): “Maternal care due to uterine scar from previous surgery (O34.2-)” · check together

Referenced by Excludes2 notes

  • O99.8 — Other specified diseases and conditions complicating pregnancy, childbirth and the puerperium [Excludes2](via O34.-): “maternal care for known or suspected abnormality of maternal pelvic organs (O34.-)” · check together

Referenced by Code First instructions

  • O75.82 — Onset (spontaneous) of labor after 37 completed weeks of gestation but before 39 completed weeks gestation, with delivery by (planned) cesarean section [Code First](via O34.21.-): “previous cesarean delivery (O34.21-)” · check together

Clinical classification (CCSR)

  • PRG016 — Previous C-section [CCSR]

Potential MS-DRG

  • DRG 817 — OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC [MS-DRG]: “OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC (MDC 14)”
  • DRG 818 — OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC [MS-DRG]: “OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC (MDC 14)”
  • DRG 819 — OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC [MS-DRG]: “OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC (MDC 14)”
  • DRG 831 — OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC [MS-DRG]: “OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC (MDC 14)”
  • DRG 832 — OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC [MS-DRG]: “OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC (MDC 14)”
  • DRG 833 — OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC [MS-DRG]: “OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC (MDC 14)”

MDC crossing · procedures (94)

  • MDC 14 — Pregnancy, Childbirth and the Puerperium [MDC crossing]: “Pregnancy, Childbirth and the Puerperium — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 0U570ZZ — Destruction of Bilateral Fallopian Tubes, Open Approach [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Open Approach — grouped in MDC 14, the procedure side of this code's crossing.” · check together
  • 0U573ZZ — Destruction of Bilateral Fallopian Tubes, Percutaneous Approach [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Percutaneous Approach — grouped in MDC 14, the procedure side of this code's crossing.” · check together
  • 0U574ZZ — Destruction of Bilateral Fallopian Tubes, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Percutaneous Endoscopic Approach — grouped in MDC 14, the procedure side of this code's crossing.” · check together
  • 0U577ZZ — Destruction of Bilateral Fallopian Tubes, Via Natural or Artificial Opening [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Via Natural or Artificial Opening — grouped in MDC 14, the procedure side of this code's crossing.” · check together
  • 0U578ZZ — Destruction of Bilateral Fallopian Tubes, Via Natural or Artificial Opening Endoscopic [Same-MDC procedure]: “Destruction of Bilateral Fallopian Tubes, Via Natural or Artificial Opening Endoscopic — grouped in MDC 14, the procedure side of this code's crossing.” · check together
  • and 89 more

Index entries

  • Cesarean delivery, previous, affecting management of pregnancy[Index term]
  • Delivery (childbirth) (labor), cesarean (for), previous, cesarean delivery[Index term]
  • Delivery (childbirth) (labor), cesarean (for), scar (s), cesarean delivery[Index term]
  • Delivery (childbirth) (labor), vaginal, following previous cesarean delivery[Index term]

Nearest codes (40)

  • O34 — Maternal care for abnormality of pelvic organs [Sibling]
  • O34.0 — Maternal care for congenital malformation of uterus [Sibling]
  • O34.00 — Maternal care for unspecified congenital malformation of uterus, unspecified trimester [Sibling]
  • O34.01 — Maternal care for unspecified congenital malformation of uterus, first trimester [Sibling]
  • O34.02 — Maternal care for unspecified congenital malformation of uterus, second trimester [Sibling]
  • O34.03 — Maternal care for unspecified congenital malformation of uterus, third trimester [Sibling]
  • O34.1 — Maternal care for benign tumor of corpus uteri [Sibling]
  • O34.10 — Maternal care for benign tumor of corpus uteri, unspecified trimester [Sibling]
  • and 32 more

Change history

  • FY2017 — Added to the code set [Change history]

Referenced by Other Codes

Clinical classification (AHRQ CCSR):PRG016 — Previous C-section (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Potential MS-DRG Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 6 MS-DRGs: DRG 817 (MDC 14), DRG 818 (MDC 14), DRG 819 (MDC 14), DRG 831 (MDC 14), DRG 832 (MDC 14), DRG 833 (MDC 14).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Official ICD-10-CM tabular notes on other codes that name O34.219 or its code family.

1 Excludes1 notes: Z98.891 (via O34.2.-).

1 Excludes2 notes: O99.8 (via O34.-).

1 Code First instructions: O75.82 (via O34.21.-).

Nearest Codes in This Family

Official ICD-10-CM classifications closest to O34.219 in its code family, with their registry titles.

  • O34.2 — Maternal care due to uterine scar from previous surgery
  • O34.21 — Maternal care for scar from previous cesarean delivery
  • O34.211 — Maternal care for low transverse scar from previous cesarean delivery
  • O34.212 — Maternal care for vertical scar from previous cesarean delivery
  • O34.218 — Maternal care for other type scar from previous cesarean delivery
  • O34.22 — Maternal care for cesarean scar defect (isthmocele)
  • O34.29 — Maternal care due to uterine scar from other previous surgery
  • O34.3 — Maternal care for cervical incompetence
  • O34.30 — Maternal care for cervical incompetence, unspecified trimester
  • O34.31 — Maternal care for cervical incompetence, first trimester

View all codes in the O34 family

Indexed Clinical Terms (4)

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code.

  • Cesarean delivery, previous, affecting management of pregnancy
  • Delivery (childbirth) (labor), cesarean (for), previous, cesarean delivery
  • Delivery (childbirth) (labor), cesarean (for), scar (s), cesarean delivery
  • Delivery (childbirth) (labor), vaginal, following previous cesarean delivery