Complications Occurring Mainly in The Course of Labor and Delivery ICD 9 Codes (660-669)

COMPLICATIONS OCCURRING MAINLY IN THE COURSE OF LABOR AND DELIVERY ICD 9 CODES (660-669)

The following fifth-digit subclassification is for use with categories 660-669 to denote the current episode of care:

0 unspecified as to episode of care or not applicable

1 delivered, with or without mention of antepartum condition

2 delivered, with mention of postpartum complication

3 antepartum condition or complication

4 postpartum condition or complication

660       Obstructed labor   (ICD 9 CM Codes)

Requires fifth digit; valid digits are in [brackets] under each code.  see beginning of section 660-669 for definitions.

660.0    Obstruction caused by malposition of fetus at onset of labor

[0,1,3]

Any condition classifiable to 652, causing obstruction during labor

Use additional code from 652.0-652.9 to identify condition

660.1    Obstruction by bony pelvis

[0,1,3]

Any condition classifiable to 653, causing obstruction during labor

Use additional code from 653.0-653.9 to identify condition

660.2    Obstruction by abnormal pelvic soft tissues

[0,1,3]

Prolapse of anterior lip of cervix

Any condition classifiable to 654, causing obstruction during labor

Use additional code from 654.0-654.9 to identify condition

660.3    Deep transverse arrest and persistent occipitoposterior position

[0,1,3]

660.4    Shoulder (girdle) dystocia

[0,1,3]

Impacted shoulders

660.5    Locked twins

[0,1,3]

660.6    Failed trial of labor, unspecified

[0,1,3]

Failed trial of labor, without mention of condition or suspected condition

660.7    Failed forceps or vacuum extractor, unspecified

[0,1,3]

Application of ventouse or forceps, without mention of condition

660.8    Other causes of obstructed labor

[0,1,3]

Use additional code to identify condition

660.9    Unspecified obstructed labor

[0,1,3]

Dystocia:

NOS

fetal NOS

maternal NOS

661       Abnormality of forces of labor    (ICD 9 CM Codes)

Requires fifth digit; valid digits are in [brackets] under each code.  see beginning of section 660-669 for definitions.

661.0    Primary uterine inertia

[0,1,3]

Failure of cervical dilation

Hypotonic uterine dysfunction, primary

Prolonged latent phase of labor

661.1    Secondary uterine inertia

[0,1,3]

Arrested active phase of labor

Hypotonic uterine dysfunction, secondary

661.2    Other and unspecified uterine inertia

[0,1,3]

Atony of uterus without hemorrhage

Desultory labor

Irregular labor

Poor contractions

Slow slope active phase of labor

Excludes: atony of uterus with hemorrhage (666.1)

postpartum atony of uterus without hemorrhage (669.8)

661.3    Precipitate labor

[0,1,3]

661.4    Hypertonic, incoordinate, or prolonged uterine contractions

[0,1,3]

Cervical spasm

Contraction ring (dystocia)

Dyscoordinate labor

Hourglass contraction of uterus

Hypertonic uterine dysfunction

Incoordinate uterine action

Retraction ring (Bandl's) (pathological)

Tetanic contractions

Uterine dystocia NOS

Uterine spasm

661.9    Unspecified abnormality of labor

[0,1,3]

662       Long labor           (ICD 9 CM Codes)

Requires fifth digit; valid digits are in [brackets] under each code.  see beginning of section 660-669 for definitions.

662.0    Prolonged first stage

[0,1,3]

662.1    Prolonged labor, unspecified

[0,1,3]

662.2    Prolonged second stage

[0,1,3]

662.3    Delayed delivery of second twin, triplet, etc.

[0,1,3]

663       Umbilical cord complications         (ICD 9 CM Codes)

Requires fifth digit; valid digits are in [brackets] under each code.  see beginning of section 660-669 for definitions.

663.0    Prolapse of cord

[0,1,3]

Presentation of cord

663.1    Cord around neck, with compression

[0,1,3]

Cord tightly around neck

663.2    Other and unspecified cord entanglement, with compression

[0,1,3]

Entanglement of cords of twins in mono-amniotic sac

Knot in cord (with compression)

663.3    Other and unspecified cord entanglement, without mention of compression

[0,1,3]

663.4    Short cord

[0,1,3]

663.5    Vasa previa

[0,1,3]

663.6    Vascular lesions of cord

[0,1,3]

Bruising of cord

Hematoma of cord

Thrombosis of vessels of cord

663.8    Other umbilical cord complications

[0,1,3]

Velamentous insertion of umbilical cord

663.9    Unspecified umbilical cord complication

[0,1,3]

664       Trauma to perineum and vulva during delivery   (ICD 9 CM Codes)

Requires fifth digit; valid digits are in [brackets] under each code.  see beginning of section 660-669 for definitions.

Includes:     damage from instruments

that from extension of episiotomy

664.0    First-degree perineal laceration

[0,1,4]

Perineal laceration, rupture, or tear involving:

fourchette

hymen

labia

skin

vagina

vulva

664.1    Second-degree perineal laceration

[0,1,4]

Perineal laceration, rupture, or tear (following episiotomy) involving:

pelvic floor

perineal muscles

vaginal muscles

Excludes: that involving anal sphincter (664.2)

664.2    Third-degree perineal laceration

[0,1,4]

Perineal laceration, rupture, or tear (following episiotomy) involving:

anal sphincter

rectovaginal septum

sphincter NOS

Excludes: anal sphincter tear during delivery not associated with third-degree perineal laceration (664.6)

that with anal or rectal mucosal laceration (664.3)

664.3    Fourth-degree perineal laceration

[0,1,4]

Perineal laceration, rupture, or tear as classifiable to 664.2 and involving also:

anal mucosa

rectal mucosa

664.4    Unspecified perineal laceration

[0,1,4]

Central laceration

664.5    Vulval and perineal hematoma

[0,1,4]

664.6    Anal sphincter tear complicating delivery, not associated with third-degree perineal laceration

[0,1,4]

Excludes: third-degree perineal laceration (664.2)

664.8    Other specified trauma to perineum and vulva

[0,1,4]

Periurethral trauma

664.9    Unspecified trauma to perineum and vulva

[0,1,4]

665       Other obstetrical trauma       (ICD 9 CM Codes)

Requires fifth digit; valid digits are in [brackets] under each code.  see beginning of section 660-669 for definitions.

Includes:     damage from instruments

665.0    Rupture of uterus before onset of labor

[0,1,3]

665.1    Rupture of uterus during labor

[0,1]

Rupture of uterus NOS

665.2    Inversion of uterus

[0,2,4]

665.3    Laceration of cervix

[0,1,4]

665.4    High vaginal laceration

[0,1,4]

Laceration of vaginal wall or sulcus without mention of perineal laceration

665.5    Other injury to pelvic organs

[0,1,4]

Injury to:

bladder

urethra

Excludes: periurethral trauma (664.8)

665.6    Damage to pelvic joints and ligaments

[0,1,4]

Avulsion of inner symphyseal cartilage

Damage to coccyx

Separation of symphysis (pubis)

665.7    Pelvic hematoma

[0-2,4]

Hematoma of vagina

665.8    Other specified obstetrical trauma

[0-4]

665.9    Unspecified obstetrical trauma

[0-4]

666       Postpartum hemorrhage   (ICD 9 CM Codes)

Requires fifth digit; valid digits are in [brackets] under each code.  see beginning of section 660-669 for definitions.

666.0    Third-stage hemorrhage

[0,2,4]

Hemorrhage associated with retained, trapped, or adherent placenta

Retained placenta NOS

666.1    Other immediate postpartum hemorrhage

[0,2,4]

Atony of uterus with hemorrhage

Hemorrhage within the first 24 hours following delivery of placenta

Postpartum atony of uterus with hemorrhage

Postpartum hemorrhage (atonic) NOS

Excludes: atony of uterus without hemorrhage (661.2)

postpartum atony of uterus without hemorrhage (669.8)

666.2    Delayed and secondary postpartum hemorrhage

[0,2,4]

Hemorrhage:

after the first 24 hours following delivery

associated with retained portions of placenta or membranes

Postpartum hemorrhage specified as delayed or secondary

Retained products of conception NOS, following delivery

666.3    Postpartum coagulation defects

[0,2,4]

Postpartum:

afibrinogenemia

fibrinolysis

667       Retained placenta without hemorrhage   (ICD 9 CM Codes)

Requires fifth digit; valid digits are in [brackets] under each code.  see beginning of section 660-669 for definitions.

667.0    Retained placenta without hemorrhage

[0,2,4]

Placenta accreta without hemorrhage

Retained placenta:

NOS without hemorrhage

total without hemorrhage

667.1    Retained portions of placenta or membranes, without hemorrhage

[0,2,4]

Retained products of conception following delivery, without hemorrhage

668       Complications of the administration of anesthetic or other sedation in labor and delivery

Use additional code(s) to further specify complication

Requires fifth digit; valid digits are in [brackets] under each code.  see beginning of section 660-669 for definitions.

Includes:     complications arising from the administration of a general or local anesthetic, analgesic, or other sedation in labor and delivery

Excludes:    reaction to spinal or lumbar puncture (349.0)

spinal headache (349.0)

668.0    Pulmonary complications

[0-4]

Inhalation [aspiration] of stomach contents or secretions following anesthesia or other sedation in labor or delivery

Mendelson's syndrome following anesthesia or other sedation in labor or delivery

Pressure collapse of lung following anesthesia or other sedation in labor or delivery

668.1    Cardiac complications

[0-4]

Cardiac arrest or failure following anesthesia or other sedation in labor and delivery

668.2    Central nervous system complications

[0-4]

Cerebral anoxia following anesthesia or other sedation in labor and delivery

668.8    Other complications of anesthesia or other sedation in labor and delivery

[0-4]

668.9    Unspecified complication of anesthesia and other sedation

[0-4]

669       Other complications of labor and delivery, not elsewhere classified   (ICD 9 CM Codes)

Requires fifth digit; valid digits are in [brackets] under each code.  see beginning of section 660-669 for definitions.

669.0    Maternal distress

[0-4]

Metabolic disturbance in labor and delivery

669.1    Shock during or following labor and delivery

[0-4]

Obstetric shock

669.2    Maternal hypotension syndrome

[0-4]

669.3    Acute kidney failure following labor and delivery

[0,2,4]

669.4    Other complications of obstetrical surgery and procedures

[0-4]

Cardiac:

arrest following cesarean or other obstetrical surgery or procedure, including delivery NOS

failure following cesarean or other obstetrical surgery or procedure, including delivery NOS

Cerebral anoxia following cesarean or other obstetrical surgery or procedure, including delivery NOS

Excludes: complications of obstetrical surgical wounds (674.1-674.3)

669.5    Forceps or vacuum extractor delivery without mention of indication

[0,1]

Delivery by ventouse, without mention of indication

669.6    Breech extraction, without mention of indication

[0,1]

Excludes: breech delivery NOS (652.2)

669.7    Cesarean delivery, without mention of indication

[0,1]

669.8    Other complications of labor and delivery

[0-4]

669.9    Unspecified complication of labor and delivery

[0-4]

(ICD 9 CM Codes)