Question: I need help with the ICD-10-CM diagnosis codes for this ob patient. The patient had a cesarean delivery due to the following diagnosis: 1. Failure to descend in second stage of labor 2. Failed vacuum delivery 3. Cephalopelvic disproportion My question is do I code the failure to descent causing obstructed labor? Or do I code the cephalopelvic disproportion causing obstructed labor? Or do I code these both (diagnosis 1&2) causing obstructed labor? Arkansas Subscriber Answer: Cephalopelvic disproportion is O65.4 (Obstructed labor due to fetopelvic disproportion, unspecified), which is the same thing as fetopelvic disproportion. And it would be this condition that led to failure of descent (O62.1, Secondary uterine inertia). The failed vacuum delivery then should also be mentioned (O66.5, Attempted application of vacuum extractor and forceps).