Coding a VBAC Delivery: When to Use O34.21-

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Code sets: FY 2027 ICD-10-CM; CY 2026 CPT.

The question

A patient with a prior cesarean delivers vaginally (VBAC). The provider does not say the old scar complicated anything. Do you still code the scar?

The answer

Yes. A previous cesarean scar affects the management of labor and delivery, so it is reported on the delivery record with O34.21- (Maternal care for scar from previous cesarean delivery). This is why O80 (full-term uncomplicated delivery) is not used for a VBAC.

AHA Coding Clinic (Third Quarter 2018) addressed this directly: for a successful vaginal birth after a previous cesarean with the scar type not specified, assign O34.219; when a previous low transverse cesarean is documented, assign O34.211 (summarized in the CCO Supervision of Pregnancy Clinical Documentation Guide).

Pick the scar type

  • O34.211 Low transverse scar.

  • O34.212 Vertical (classical) scar.

  • O34.218 Other type of scar, such as a mid-transverse T incision.

  • O34.219 Unspecified type of scar.

  • O34.22 Cesarean scar defect (isthmocele), when documented.

O34.21- codes do not carry a trimester character.

Other codes on the delivery record

  • Z37.0 Single live birth (or the correct Z37 code). A Z37 outcome code goes on every maternal record when a delivery occurs (FY 2027 ICD-10-CM Guidelines, Section I.C.15.b.5).

  • The weeks of gestation code from category Z3A.

  • Do not add Z98.891 (history of uterine scar). Its Excludes1 note bars it with O34.2- during pregnancy.

Failed VBAC

If labor is attempted and the patient ends up with a cesarean, use O66.41 Failed attempted vaginal birth after previous cesarean delivery, along with the scar code.

CPT side

Through December 31, 2026, a successful VBAC is reported with 59610-59614 (global or component VBAC codes), and a failed trial of labor ending in cesarean uses 59618-59622.

Coming January 1, 2027: CPT 2027 restructures delivery care. A VBAC delivery is reported with new code 59432 (vaginal delivery after previous cesarean delivery), a cesarean after a previous cesarean is 59503 whether or not labor was attempted, and labor management for a patient seeking VBAC may be reported separately (AMA: CPT 2027 coding for delivery care).

Refreshed from the CCO Community archive, November 2026.