Wiki Breech delivery--When to use O32 VS O64??

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Since I'm new to coding OB/GYN, I was looking for guidance on which category to use for coding deliveries when the baby is breech.
O32 category is Maternal Care for malpresentation of fetus and O64 is Obstructed labor due to malposition and malpresentation of fetus?
Any input would be much appreciated, thank you :)
Jaime
 
Hi, Jamie, your post from 2016 is still relevant today. I wonder if you ever got an answer to your question, or if you have learned the answer through experience? If you are still out there trolling the AAPC forums and come across this posting, please let me know the answer to your question. I'm looking for the answer to the same question. Thanks! Good luck!
 
Hello I’m still learning OB/GYN specialty. A few months ago an expert on deliveries answered this question to a different post. And the answer was if there is a breach presentation during a delivery we use O64-, and for prenatal maternal visits we use O32- codes. Try to find that post by using search box in this forum. 😊
 
Hello, I have a following question to C-S delivery when thick meconium is found O77.0. The main Dx for C-section is Fetal intolerance of labor O76. Under findings MD listed thick meconium. Will it be appropriate to code O77.0 for pt who is delivering via C-section?
O77.0-Labor and delivery complicated by meconium in amniotic fluid
Thank you very much in advance!
 
natashalage said:
Hello, I have a following question to C-S delivery when thick meconium is found O77.0. The main Dx for C-section is Fetal intolerance of labor O76. Under findings MD listed thick meconium. Will it be appropriate to code O77.0 for pt who is delivering via C-section?
O77.0-Labor and delivery complicated by meconium in amniotic fluid
Thank you very much in advance!
Click to expand...
As he has documented this finding, then yes, you should code it as a complication which also led to the decision to perform the cesarean. The literature indicates that thick meconium is one of many indications for a cesarean delivery.
 
natashalage said:
Hello, I have a following question to C-S delivery when thick meconium is found O77.0. The main Dx for C-section is Fetal intolerance of labor O76. Under findings MD listed thick meconium. Will it be appropriate to code O77.0 for pt who is delivering via C-section?
O77.0-Labor and delivery complicated by meconium in amniotic fluid
Thank you very much in advance!
Click to expand...
Also, in future (and so others can search on an answer to a similar question) it would be good to start a new thread with a different title as your question appears under the heading of the original question but it not related to it (breech delivery and obstructed labor). Thanks.
 
Thank you very much for your responses! I would like to confirm I understood that correctly about O32 vs O64 for C-s delivery.
When the patient is scheduled for C-s delivery and the dx: Fetal breech + let's say Anemia, we use O32 and not O64 because it was planned, scheduled C-s? per above comment from Cmama12.
I don't understand this statement "before onset of labor" under O32-"The listed conditions as a reason for observation, hospitalization or other obstetric care of the mother, or for cesarean delivery before onset of labor".
Me thinking: pregnant pt have US, so MD knows that there is a fetal breech and if pt is having Vaginal delivery, that will be O64-obstructed labor and delivery. In what cases we would code O64 for c-s section? Fetal beech? Then even for a Scheduled, planned C-s delivery, we should use O64- because we know ahead of time that pt cannot delivery vaginally and that's why we are scheduling C-s delivery.
Confused coder needs help.:unsure:
 
natashalage said:
Thank you very much for your responses! I would like to confirm I understood that correctly about O32 vs O64 for C-s delivery.
When the patient is scheduled for C-s delivery and the dx: Fetal breech + let's say Anemia, we use O32 and not O64 because it was planned, scheduled C-s? per above comment from Cmama12.
I don't understand this statement "before onset of labor" under O32-"The listed conditions as a reason for observation, hospitalization or other obstetric care of the mother, or for cesarean delivery before onset of labor".
Me thinking: pregnant pt have US, so MD knows that there is a fetal breech and if pt is having Vaginal delivery, that will be O64-obstructed labor and delivery. In what cases we would code O64 for c-s section? Fetal beech? Then even for a Scheduled, planned C-s delivery, we should use O64- because we know ahead of time that pt cannot delivery vaginally and that's why we are scheduling C-s delivery.
Confused coder needs help.:unsure:
Click to expand...
Hi, because sometimes the mother comes in in labor and they discover the baby is breech at that time, or even if they know about the breech and a c- sect is planned, the patient goes into labor as in the examples below.

xxx is a 23 year old G1P0 female at 37w5d gestation presenting with persistent uterine contractions since 12:30 a.m. and found to be 5 cm dilated. Her current pregnancy is significant for fetal breech presentation, GBS colonization, and Wolff-Parkinson-White syndrome.

xx is a 32 year old G2P0010 female at 38w3d gestation presenting with persistent contractions and found to be 5 cm dilated in breech presentation.

And here is one where I would use O32
The patient is a G3P1021 at 39w4d admitted for scheduled primary cesarean section for breech presentation.
 
sorry, I am still confused. Your 2 examples related to C-section or Vaginal? Probably C-section because I asked for examples. And the last example ... for O32-. The key word will be ' scheduled" C-section. Unfortunately, I don't' see in our Op notes "Scheduled C-section." In our practice, we provide global prenatal visits, US and MD knows ahead of time that pt has a fetal breech, and then they schedule C-section. But the Delivery note itself does not have the word 'scheduled" Will it be O32 or O64?
I arrived to the conclusion and please correct me if I am wrong (which is more likely): If pt has Vaginal or C-section delivery with fetal breech (discovered no matter when), we code O64. If you see the word " scheduled C-section in the Delivery note you code", we use O32-. Is that right?
What an interesting topic that has so much details. Dear Cmama12, Thank you So Much for your patience with me and willing to help. I also appreciate everybody's response as well. It's a nationwide forum! Thank you to all of you! :)
 
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