Anesthesia Coding Alert

Reader Question:

List O34.211 Before O80 on Your Claim

Question: I have been told the code for a successful VBAC would be submitted as O34.211/O80 but I am a doubtful on this sequence. Can you please tell me the anesthesia codes for a successful and unsuccessful VBAC after a C-section and in what order they should appear on a claim?

New York Subscriber

Answer: The correct anesthesia code for vaginal delivery is 01960 (Anesthesia for vaginal delivery only). You report anesthesia for cesarean delivery as 01961 (Anesthesia for cesarean delivery only).

Your diagnosis sequence is correct. List O34.211 (Maternal care for low transverse scar from previous cesarean delivery) first on the claim and then O80 (Encounter for full-term uncomplicated delivery).

Extra help: The following criteria must be met in order to assign diagnosis O80:

  • Single, full term and live born baby (full term is 37 weeks to 40 weeks gestation)
  • Head first (cephalic) presentation
  • Little to no assistance during delivery (episiotomy does not affect code assignment).
  • No current antepartum or postpartum complication.

The correct diagnosis code for an unsuccessful VBAC will depend on the reason why it was unsuccessful, such as fetal distress.


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