In the realm of medical coding and healthcare services, accurate classification and categorization of diagnoses and procedures are paramount. Diagnosis Related Groups (DRGs) serve as a cornerstone in this system, particularly within the Medicare and Medicaid Services. For professionals in medical billing, coding, and healthcare administration, understanding the intricacies of DRGs is crucial for proper reimbursement and healthcare management. This article delves into DRG 774, specifically focusing on “Vaginal Delivery with Complicating Diagnoses”. We will explore the conditions and diagnosis codes that define this DRG, providing a comprehensive overview for those navigating the complexities of medical coding, especially in the context of Delivery Diagnosis Codes.
DRG 774, as defined within MDC 14 (Pregnancy, Childbirth & the Puerperium), is triggered when a vaginal delivery is accompanied by certain complicating factors. It is essential to note that DRG 774 has specific criteria that must be met, involving principal or secondary diagnoses, delivery procedures, or delivery outcome secondary diagnoses. Let’s break down these conditions to gain a clearer understanding of when DRG 774 is applicable.
First Condition: Vaginal Delivery
The primary requirement for DRG 774 is a vaginal delivery. This is further specified by a set of diagnosis codes that must be present as either the principal or secondary diagnosis. These codes encompass a range of conditions complicating childbirth, ensuring that deliveries with added complexities are appropriately categorized. Below is a list of ICD-10 codes that fulfill this first condition:
- O1002 – Pre-existing essential hypertension complicating childbirth
- O1012 – Pre-existing hypertensive heart disease complicating childbirth
- O1022 – Pre-existing hypertensive chronic kidney disease complicating childbirth
- O1032 – Pre-existing hypertensive heart and chronic kidney disease complicating childbirth
- O1042 – Pre-existing secondary hypertension complicating childbirth
- O1092 – Unspecified pre-existing hypertension complicating childbirth
- O151 – Eclampsia in labor
- O2402 – Pre-existing diabetes mellitus, type 1, in childbirth
- O2412 – Pre-existing diabetes mellitus, type 2, in childbirth
- O2432 – Unspecified pre-existing diabetes mellitus in childbirth
- O24420 – Gestational diabetes mellitus in childbirth, diet controlled
- O24424 – Gestational diabetes mellitus in childbirth, insulin controlled
- O24429 – Gestational diabetes mellitus in childbirth, unspecified control
- O2482 – Other pre-existing diabetes mellitus in childbirth
- O2492 – Unspecified diabetes mellitus in childbirth
- O252 – Malnutrition in childbirth
- O2662 – Liver and biliary tract disorders in childbirth
- O2672 – Subluxation of symphysis (pubis) in childbirth
- O6012x0 – Preterm labor second trimester with preterm delivery second trimester, not applicable or unspecified
- O6012x1 – Preterm labor second trimester with preterm delivery second trimester, fetus 1
- O6012x2 – Preterm labor second trimester with preterm delivery second trimester, fetus 2
- O6012x3 – Preterm labor second trimester with preterm delivery second trimester, fetus 3
- O6012x4 – Preterm labor second trimester with preterm delivery second trimester, fetus 4
- O6012x5 – Preterm labor second trimester with preterm delivery second trimester, fetus 5
- O6012x9 – Preterm labor second trimester with preterm delivery second trimester, other fetus
- O6013x0 – Preterm labor second trimester with preterm delivery third trimester, not applicable or unspecified
- O6013x1 – Preterm labor second trimester with preterm delivery third trimester, fetus 1
- O6013x2 – Preterm labor second trimester with preterm delivery third trimester, fetus 2
- O6013x3 – Preterm labor second trimester with preterm delivery third trimester, fetus 3
- O6013x4 – Preterm labor second trimester with preterm delivery third trimester, fetus 4
- O6013x5 – Preterm labor second trimester with preterm delivery third trimester, fetus 5
- O6013x9 – Preterm labor second trimester with preterm delivery third trimester, other fetus
- O6014x0 – Preterm labor third trimester with preterm delivery third trimester, not applicable or unspecified
- O6014x1 – Preterm labor third trimester with preterm delivery third trimester, fetus 1
- O6014x2 – Preterm labor third trimester with preterm delivery third trimester, fetus 2
- O6014x3 – Preterm labor third trimester with preterm delivery third trimester, fetus 3
- O6014x4 – Preterm labor third trimester with preterm delivery third trimester, fetus 4
- O6014x5 – Preterm labor third trimester with preterm delivery third trimester, fetus 5
- O6014x9 – Preterm labor third trimester with preterm delivery third trimester, other fetus
- O6022x0 – Term delivery with preterm labor, second trimester, not applicable or unspecified
- O6022x1 – Term delivery with preterm labor, second trimester, fetus 1
- O6022x2 – Term delivery with preterm labor, second trimester, fetus 2
- O6022x3 – Term delivery with preterm labor, second trimester, fetus 3
- O6022x4 – Term delivery with preterm labor, second trimester, fetus 4
- O6022x5 – Term delivery with preterm labor, second trimester, fetus 5
- O6022x9 – Term delivery with preterm labor, second trimester, other fetus
- O6023x0 – Term delivery with preterm labor, third trimester, not applicable or unspecified
- O6023x1 – Term delivery with preterm labor, third trimester, fetus 1
- O6023x2 – Term delivery with preterm labor, third trimester, fetus 2
- O6023x3 – Term delivery with preterm labor, third trimester, fetus 3
- O6023x4 – Term delivery with preterm labor, third trimester, fetus 4
- O6023x5 – Term delivery with preterm labor, third trimester, fetus 5
- O6023x9 – Term delivery with preterm labor, third trimester, other fetus
- O640xx0 – Obstructed labor due to incomplete rotation of fetal head, not applicable or unspecified
- O640xx1 – Obstructed labor due to incomplete rotation of fetal head, fetus 1
- O640xx2 – Obstructed labor due to incomplete rotation of fetal head, fetus 2
- O640xx3 – Obstructed labor due to incomplete rotation of fetal head, fetus 3
- O640xx4 – Obstructed labor due to incomplete rotation of fetal head, fetus 4
- O640xx5 – Obstructed labor due to incomplete rotation of fetal head, fetus 5
- O640xx9 – Obstructed labor due to incomplete rotation of fetal head, other fetus
- O641xx0 – Obstructed labor due to breech presentation, not applicable or unspecified
- O641xx1 – Obstructed labor due to breech presentation, fetus 1
- O641xx2 – Obstructed labor due to breech presentation, fetus 2
- O641xx3 – Obstructed labor due to breech presentation, fetus 3
- O641xx4 – Obstructed labor due to breech presentation, fetus 4
- O641xx5 – Obstructed labor due to breech presentation, fetus 5
- O641xx9 – Obstructed labor due to breech presentation, other fetus
- O642xx0 – Obstructed labor due to face presentation, not applicable or unspecified
- O642xx1 – Obstructed labor due to face presentation, fetus 1
- O642xx2 – Obstructed labor due to face presentation, fetus 2
- O642xx3 – Obstructed labor due to face presentation, fetus 3
- O642xx4 – Obstructed labor due to face presentation, fetus 4
- O642xx5 – Obstructed labor due to face presentation, fetus 5
- O642xx9 – Obstructed labor due to face presentation, other fetus
- O643xx0 – Obstructed labor due to brow presentation, not applicable or unspecified
- O643xx1 – Obstructed labor due to brow presentation, fetus 1
- O643xx2 – Obstructed labor due to brow presentation, fetus 2
- O643xx3 – Obstructed labor due to brow presentation, fetus 3
- O643xx4 – Obstructed labor due to brow presentation, fetus 4
- O643xx5 – Obstructed labor due to brow presentation, fetus 5
- O643xx9 – Obstructed labor due to brow presentation, other fetus
- O644xx0 – Obstructed labor due to shoulder presentation, not applicable or unspecified
- O644xx1 – Obstructed labor due to shoulder presentation, fetus 1
- O644xx2 – Obstructed labor due to shoulder presentation, fetus 2
- O644xx3 – Obstructed labor due to shoulder presentation, fetus 3
- O644xx4 – Obstructed labor due to shoulder presentation, fetus 4
- O644xx5 – Obstructed labor due to shoulder presentation, fetus 5
- O644xx9 – Obstructed labor due to shoulder presentation, other fetus
- O645xx0 – Obstructed labor due to compound presentation, not applicable or unspecified
- O645xx1 – Obstructed labor due to compound presentation, fetus 1
- O645xx2 – Obstructed labor due to compound presentation, fetus 2
- O645xx3 – Obstructed labor due to compound presentation, fetus 3
- O645xx4 – Obstructed labor due to compound presentation, fetus 4
- O645xx5 – Obstructed labor due to compound presentation, fetus 5
- O645xx9 – Obstructed labor due to compound presentation, other fetus
- O648xx0 – Obstructed labor due to other malposition and malpresentation, not applicable or unspecified
- O648xx1 – Obstructed labor due to other malposition and malpresentation, fetus 1
- O648xx2 – Obstructed labor due to other malposition and malpresentation, fetus 2
- O648xx3 – Obstructed labor due to other malposition and malpresentation, fetus 3
- O648xx4 – Obstructed labor due to other malposition and malpresentation, fetus 4
- O648xx5 – Obstructed labor due to other malposition and malpresentation, fetus 5
- O648xx9 – Obstructed labor due to other malposition and malpresentation, other fetus
- O649xx0 – Obstructed labor due to malposition and malpresentation, unspecified, not applicable or unspecified
- O649xx1 – Obstructed labor due to malposition and malpresentation, unspecified, fetus 1
- O649xx2 – Obstructed labor due to malposition and malpresentation, unspecified, fetus 2
- O649xx3 – Obstructed labor due to malposition and malpresentation, unspecified, fetus 3
- O649xx4 – Obstructed labor due to malposition and malpresentation, unspecified, fetus 4
- O649xx5 – Obstructed labor due to malposition and malpresentation, unspecified, fetus 5
- O649xx9 – Obstructed labor due to malposition and malpresentation, unspecified, other fetus
- O650 – Obstructed labor due to deformed pelvis
- O651 – Obstructed labor due to generally contracted pelvis
- O652 – Obstructed labor due to pelvic inlet contraction
- O653 – Obstructed labor due to pelvic outlet and mid-cavity contraction
- O654 – Obstructed labor due to fetopelvic disproportion, unspecified
- O655 – Obstructed labor due to abnormality of maternal pelvic organs
- O658 – Obstructed labor due to other maternal pelvic abnormalities
- O659 – Obstructed labor due to maternal pelvic abnormality, unspecified
- O660 – Obstructed labor due to shoulder dystocia
- O661 – Obstructed labor due to locked twins
- O662 – Obstructed labor due to unusually large fetus
- O663 – Obstructed labor due to other abnormalities of fetus
- O6641 – Failed attempted vaginal birth after previous cesarean delivery
- O665 – Attempted application of vacuum extractor and forceps
- O666 – Obstructed labor due to other multiple fetuses
- O668 – Other specified obstructed labor
- O669 – Obstructed labor, unspecified
- O670 – Intrapartum hemorrhage with coagulation defect
- O678 – Other intrapartum hemorrhage
- O679 – Intrapartum hemorrhage, unspecified
- O68 – Labor and delivery complicated by abnormality of fetal acid-base balance
- O690xx0 – Labor and delivery complicated by prolapse of cord, not applicable or unspecified
- O690xx1 – Labor and delivery complicated by prolapse of cord, fetus 1
- O690xx2 – Labor and delivery complicated by prolapse of cord, fetus 2
- O690xx3 – Labor and delivery complicated by prolapse of cord, fetus 3
- O690xx4 – Labor and delivery complicated by prolapse of cord, fetus 4
- O690xx5 – Labor and delivery complicated by prolapse of cord, fetus 5
- O690xx9 – Labor and delivery complicated by prolapse of cord, other fetus
- O691xx0 – Labor and delivery complicated by cord around neck, with compression, not applicable or unspecified
- O691xx1 – Labor and delivery complicated by cord around neck, with compression, fetus 1
- O691xx2 – Labor and delivery complicated by cord around neck, with compression, fetus 2
- O691xx3 – Labor and delivery complicated by cord around neck, with compression, fetus 3
- O691xx4 – Labor and delivery complicated by cord around neck, with compression, fetus 4
- O691xx5 – Labor and delivery complicated by cord around neck, with compression, fetus 5
- O691xx9 – Labor and delivery complicated by cord around neck, with compression, other fetus
- O692xx0 – Labor and delivery complicated by other cord entanglement, with compression, not applicable or unspecified
- O692xx1 – Labor and delivery complicated by other cord entanglement, with compression, fetus 1
- O692xx2 – Labor and delivery complicated by other cord entanglement, with compression, fetus 2
- O692xx3 – Labor and delivery complicated by other cord entanglement, with compression, fetus 3
- O692xx4 – Labor and delivery complicated by other cord entanglement, with compression, fetus 4
- O692xx5 – Labor and delivery complicated by other cord entanglement, with compression, fetus 5
- O692xx9 – Labor and delivery complicated by other cord entanglement, with compression, other fetus
- O693xx0 – Labor and delivery complicated by short cord, not applicable or unspecified
- O693xx1 – Labor and delivery complicated by short cord, fetus 1
- O693xx2 – Labor and delivery complicated by short cord, fetus 2
- O693xx3 – Labor and delivery complicated by short cord, fetus 3
- O693xx4 – Labor and delivery complicated by short cord, fetus 4
- O693xx5 – Labor and delivery complicated by short cord, fetus 5
- O693xx9 – Labor and delivery complicated by short cord, other fetus
- O694xx0 – Labor and delivery complicated by vasa previa, not applicable or unspecified
- O694xx1 – Labor and delivery complicated by vasa previa, fetus 1
- O694xx2 – Labor and delivery complicated by vasa previa, fetus 2
- O694xx3 – Labor and delivery complicated by vasa previa, fetus 3
- O694xx4 – Labor and delivery complicated by vasa previa, fetus 4
- O694xx5 – Labor and delivery complicated by vasa previa, fetus 5
- O694xx9 – Labor and delivery complicated by vasa previa, other fetus
- O695xx0 – Labor and delivery complicated by vascular lesion of cord, not applicable or unspecified
- O695xx1 – Labor and delivery complicated by vascular lesion of cord, fetus 1
- O695xx2 – Labor and delivery complicated by vascular lesion of cord, fetus 2
- O695xx3 – Labor and delivery complicated by vascular lesion of cord, fetus 3
- O695xx4 – Labor and delivery complicated by vascular lesion of cord, fetus 4
- O695xx5 – Labor and delivery complicated by vascular lesion of cord, fetus 5
- O695xx9 – Labor and delivery complicated by vascular lesion of cord, other fetus
- O6981x1 – Labor and delivery complicated by cord around neck, without compression, fetus 1
- O6981x2 – Labor and delivery complicated by cord around neck, without compression, fetus 2
- O6981x3 – Labor and delivery complicated by cord around neck, without compression, fetus 3
- O6981x4 – Labor and delivery complicated by cord around neck, without compression, fetus 4
- O6981x5 – Labor and delivery complicated by cord around neck, without compression, fetus 5
- O6981x9 – Labor and delivery complicated by cord around neck, without compression, other fetus
- O6982x1 – Labor and delivery complicated by other cord entanglement, without compression, fetus 1
- O6982x2 – Labor and delivery complicated by other cord entanglement, without compression, fetus 2
- O6982x3 – Labor and delivery complicated by other cord entanglement, without compression, fetus 3
- O6982x4 – Labor and delivery complicated by other cord entanglement, without compression, fetus 4
- O6982x5 – Labor and delivery complicated by other cord entanglement, without compression, fetus 5
- O6982x9 – Labor and delivery complicated by other cord entanglement, without compression, other fetus
- O6989x1 – Labor and delivery complicated by other cord complications, fetus 1
- O6989x2 – Labor and delivery complicated by other cord complications, fetus 2
- O6989x3 – Labor and delivery complicated by other cord complications, fetus 3
- O6989x4 – Labor and delivery complicated by other cord complications, fetus 4
- O6989x5 – Labor and delivery complicated by other cord complications, fetus 5
- O6989x9 – Labor and delivery complicated by other cord complications, other fetus
- O699xx0 – Labor and delivery complicated by cord complication, unspecified, not applicable or unspecified
- O699xx1 – Labor and delivery complicated by cord complication, unspecified, fetus 1
- O699xx2 – Labor and delivery complicated by cord complication, unspecified, fetus 2
- O699xx3 – Labor and delivery complicated by cord complication, unspecified, fetus 3
- O699xx4 – Labor and delivery complicated by cord complication, fetus 4
- O699xx5 – Labor and delivery complicated by cord complication, fetus 5
- O699xx9 – Labor and delivery complicated by cord complication, unspecified, other fetus
- O7100 – Rupture of uterus before onset of labor, unspecified trimester
- O711 – Rupture of uterus during labor
- O7181 – Laceration of uterus, not elsewhere classified
- O720 – Third-stage hemorrhage
- O721 – Other immediate postpartum hemorrhage
- O740 – Aspiration pneumonitis due to anesthesia during labor and delivery
- O741 – Other pulmonary complications of anesthesia during labor and delivery
- O742 – Cardiac complications of anesthesia during labor and delivery
- O743 – Central nervous system complications of anesthesia during labor and delivery
- O744 – Toxic reaction to local anesthesia during labor and delivery
- O745 – Spinal and epidural anesthesia-induced headache during labor and delivery
- O746 – Other complications of spinal and epidural anesthesia during labor and delivery
- O747 – Failed or difficult intubation for anesthesia during labor and delivery
- O748 – Other complications of anesthesia during labor and delivery
- O749 – Complication of anesthesia during labor and delivery, unspecified
- O751 – Shock during or following labor and delivery
- O754 – Other complications of obstetric surgery and procedures
- O755 – Delayed delivery after artificial rupture of membranes
- O7581 – Maternal exhaustion complicating labor and delivery
- O7582 – Onset (spontaneous) of labor after 37 completed weeks of gestation but before 39 completed weeks gestation, with delivery by (planned) cesarean section
- O770 – Labor and delivery complicated by meconium in amniotic fluid
- O771 – Fetal stress in labor or delivery due to drug administration
- O778 – Labor and delivery complicated by other evidence of fetal stress
- O779 – Labor and delivery complicated by fetal stress, unspecified
- O80 – Encounter for full-term uncomplicated delivery
- O82 – Encounter for cesarean delivery without indication
- O8802 – Air embolism in childbirth
- O8812 – Amniotic fluid embolism in childbirth
- O8822 – Thromboembolism in childbirth
- O8832 – Pyemic and septic embolism in childbirth
- O8882 – Other embolism in childbirth
- O9802 – Tuberculosis complicating childbirth
- O9812 – Syphilis complicating childbirth
- O9822 – Gonorrhea complicating childbirth
- O9832 – Other infections with a predominantly sexual mode of transmission complicating childbirth
- O9842 – Viral hepatitis complicating childbirth
- O9852 – Other viral diseases complicating childbirth
- O9862 – Protozoal diseases complicating childbirth
- O9872 – Human immunodeficiency virus [HIV] disease complicating childbirth
- O9882 – Other maternal infectious and parasitic diseases complicating childbirth
- O9892 – Unspecified maternal infectious and parasitic disease complicating childbirth
- O9902 – Anemia complicating childbirth
- O9912 – Other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism complicating childbirth
- O99214 – Obesity complicating childbirth
- O99284 – Endocrine, nutritional and metabolic diseases complicating childbirth
- O99314 – Alcohol use complicating childbirth
- O99324 – Drug use complicating childbirth
- O99334 – Smoking (tobacco) complicating childbirth
- O99344 – Other mental disorders complicating childbirth
- O99354 – Diseases of the nervous system complicating childbirth
- O9942 – Diseases of the circulatory system complicating childbirth
- O9952 – Diseases of the respiratory system complicating childbirth
- O9962 – Diseases of the digestive system complicating childbirth
- O9972 – Diseases of the skin and subcutaneous tissue complicating childbirth
- O99814 – Abnormal glucose complicating childbirth
- O99824 – Streptococcus B carrier state complicating childbirth
- O99834 – Other infection carrier state complicating childbirth
- O99844 – Bariatric surgery status complicating childbirth
- O9A12 – Malignant neoplasm complicating childbirth
- O9A22 – Injury, poisoning and certain other consequences of external causes complicating childbirth
- O9A32 – Physical abuse complicating childbirth
- O9A42 – Sexual abuse complicating childbirth
- O9A52 – Psychological abuse complicating childbirth
This extensive list highlights the diverse range of diagnoses that can classify a vaginal delivery under DRG 774, emphasizing that it is not just the delivery method but also the presence of complicating health issues that determine the DRG assignment.
Second Condition: Complicating Diagnosis
Beyond the vaginal delivery itself, DRG 774 can also be assigned based on the presence of a complicating diagnosis, whether as a principal or secondary diagnosis. This condition broadens the scope to include complications arising during pregnancy, childbirth, and the puerperium. The following ICD-10 codes represent the complicating diagnoses that can lead to DRG 774:
- O10011 – Pre-existing essential hypertension complicating pregnancy, first trimester
- O10012 – Pre-existing essential hypertension complicating pregnancy, second trimester
- O10013 – Pre-existing essential hypertension complicating pregnancy, third trimester
- O1002 – Pre-existing essential hypertension complicating childbirth
- O1003 – Pre-existing essential hypertension complicating the puerperium
- O10111 – Pre-existing hypertensive heart disease complicating pregnancy, first trimester
- O10112 – Pre-existing hypertensive heart disease complicating pregnancy, second trimester
- O10113 – Pre-existing hypertensive heart disease complicating pregnancy, third trimester
- O1012 – Pre-existing hypertensive heart disease complicating childbirth
- O1013 – Pre-existing hypertensive heart disease complicating the puerperium
- O10211 – Pre-existing hypertensive chronic kidney disease complicating pregnancy, first trimester
- O10212 – Pre-existing hypertensive chronic kidney disease complicating pregnancy, second trimester
- O10213 – Pre-existing hypertensive chronic kidney disease complicating pregnancy, third trimester
- O1022 – Pre-existing hypertensive chronic kidney disease complicating childbirth
- O10311 – Pre-existing hypertensive heart and chronic kidney disease complicating pregnancy, first trimester
- O10312 – Pre-existing hypertensive heart and chronic kidney disease complicating pregnancy, second trimester
- O10313 – Pre-existing hypertensive heart and chronic kidney disease complicating pregnancy, third trimester
- O1032 – Pre-existing hypertensive heart and chronic kidney disease complicating childbirth
- O10411 – Pre-existing secondary hypertension complicating pregnancy, first trimester
- O10412 – Pre-existing secondary hypertension complicating pregnancy, second trimester
- O10413 – Pre-existing secondary hypertension complicating pregnancy, third trimester
- O1042 – Pre-existing secondary hypertension complicating childbirth
- O1043 – Pre-existing secondary hypertension complicating the puerperium
- O10911 – Unspecified pre-existing hypertension complicating pregnancy, first trimester
- O10912 – Unspecified pre-existing hypertension complicating pregnancy, second trimester
- O10913 – Unspecified pre-existing hypertension complicating pregnancy, third trimester
- O1092 – Unspecified pre-existing hypertension complicating childbirth
- O111 – Pre-existing hypertension with pre-eclampsia, first trimester
- O112 – Pre-existing hypertension with pre-eclampsia, second trimester
- O113 – Pre-existing hypertension with pre-eclampsia, third trimester
- O1402 – Mild to moderate pre-eclampsia, second trimester
- O1403 – Mild to moderate pre-eclampsia, third trimester
- O1412 – Severe pre-eclampsia, second trimester
- O1413 – Severe pre-eclampsia, third trimester
- O1422 – HELLP syndrome (HELLP), second trimester
- O1423 – HELLP syndrome (HELLP), third trimester
- O1492 – Unspecified pre-eclampsia, second trimester
- O1493 – Unspecified pre-eclampsia, third trimester
- O1502 – Eclampsia in pregnancy, second trimester
- O1503 – Eclampsia in pregnancy, third trimester
- O151 – Eclampsia in labor
- O152 – Eclampsia in the puerperium
- O161 – Unspecified maternal hypertension, first trimester
- O162 – Unspecified maternal hypertension, second trimester
- O163 – Unspecified maternal hypertension, third trimester
- O169 – Unspecified maternal hypertension, unspecified trimester
- O2231 – Deep phlebothrombosis in pregnancy, first trimester
- O2232 – Deep phlebothrombosis in pregnancy, second trimester
- O2233 – Deep phlebothrombosis in pregnancy, third trimester
- O2251 – Cerebral venous thrombosis in pregnancy, first trimester
- O2252 – Cerebral venous thrombosis in pregnancy, second trimester
- O2253 – Cerebral venous thrombosis in pregnancy, third trimester
- O24011 – Pre-existing diabetes mellitus, type 1, in pregnancy, first trimester
- O24012 – Pre-existing diabetes mellitus, type 1, in pregnancy, second trimester
- O24013 – Pre-existing diabetes mellitus, type 1, in pregnancy, third trimester
- O2402 – Pre-existing diabetes mellitus, type 1, in childbirth
- O24111 – Pre-existing diabetes mellitus, type 2, in pregnancy, first trimester
- O24112 – Pre-existing diabetes mellitus, type 2, in pregnancy, second trimester
- O24113 – Pre-existing diabetes mellitus, type 2, in pregnancy, third trimester
- O2412 – Pre-existing diabetes mellitus, type 2, in childbirth
- O24311 – Unspecified pre-existing diabetes mellitus in pregnancy, first trimester
- O24312 – Unspecified pre-existing diabetes mellitus in pregnancy, second trimester
- O24313 – Unspecified pre-existing diabetes mellitus in pregnancy, third trimester
- O2432 – Unspecified pre-existing diabetes mellitus in childbirth
- O24811 – Other pre-existing diabetes mellitus in pregnancy, first trimester
- O24812 – Other pre-existing diabetes mellitus in pregnancy, second trimester
- O24813 – Other pre-existing diabetes mellitus in pregnancy, third trimester
- O2482 – Other pre-existing diabetes mellitus in childbirth
- O24911 – Unspecified diabetes mellitus in pregnancy, first trimester
- O24912 – Unspecified diabetes mellitus in pregnancy, second trimester
- O24913 – Unspecified diabetes mellitus in pregnancy, third trimester
- O2492 – Unspecified diabetes mellitus in childbirth
- O2493 – Unspecified diabetes mellitus in the puerperium
- O43211 – Placenta accreta, first trimester
- O43212 – Placenta accreta, second trimester
- O43213 – Placenta accreta, third trimester
- O43221 – Placenta increta, first trimester
- O43222 – Placenta increta, second trimester
- O43223 – Placenta increta, third trimester
- O43231 – Placenta percreta, first trimester
- O43232 – Placenta percreta, second trimester
- O43233 – Placenta percreta, third trimester
- O4401 – Placenta previa specified as without hemorrhage, first trimester
- O4402 – Placenta previa specified as without hemorrhage, second trimester
- O4403 – Placenta previa specified as without hemorrhage, third trimester
- O4411 – Placenta previa with hemorrhage, first trimester
- O4412 – Placenta previa with hemorrhage, second trimester
- O4413 – Placenta previa with hemorrhage, third trimester
- O45001 – Premature separation of placenta with coagulation defect, unspecified, first trimester
- O45002 – Premature separation of placenta with coagulation defect, unspecified, second trimester
- O45003 – Premature separation of placenta with coagulation defect, unspecified, third trimester
- O45011 – Premature separation of placenta with afibrinogenemia, first trimester
- O45012 – Premature separation of placenta with afibrinogenemia, second trimester
- O45013 – Premature separation of placenta with afibrinogenemia, third trimester
- O45021 – Premature separation of placenta with disseminated intravascular coagulation, first trimester
- O45022 – Premature separation of placenta with disseminated intravascular coagulation, second trimester
- O45023 – Premature separation of placenta with disseminated intravascular coagulation, third trimester
- O45091 – Premature separation of placenta with other coagulation defect, first trimester
- O45092 – Premature separation of placenta with other coagulation defect, second trimester
- O45093 – Premature separation of placenta with other coagulation defect, third trimester
- O458X1 – Other premature separation of placenta, first trimester
- O458X2 – Other premature separation of placenta, second trimester
- O458X3 – Other premature separation of placenta, third trimester
- O4591 – Premature separation of placenta, unspecified, first trimester
- O4592 – Premature separation of placenta, unspecified, second trimester
- O4593 – Premature separation of placenta, unspecified, third trimester
This extensive list of codes under the second condition further clarifies the breadth of complications that can lead to a vaginal delivery being classified under DRG 774. These codes range from hypertensive disorders and diabetes to placental issues and other maternal complications, highlighting the various factors that can complicate a vaginal delivery.
Third Condition: Delivery Procedure or Outcome Secondary Diagnosis
The third condition for DRG 774 focuses on specific delivery procedures performed or the outcome of the delivery, indicated as a secondary diagnosis. This condition acknowledges that certain procedures during vaginal delivery, or specific outcomes, inherently suggest a more complex case, thus warranting classification under DRG 774. The relevant procedure and outcome codes are as follows:
Delivery Procedure Codes:
- 0DQP7ZZ – Repair Rectum, Via Natural or Artificial Opening
- 10A07Z6 – Abortion of Products of Conception, Vacuum, Via Natural or Artificial Opening
- 10D07Z3 – Extraction of Products of Conception, Low Forceps, Via Natural or Artificial Opening
- 10D07Z4 – Extraction of Products of Conception, Mid Forceps, Via Natural or Artificial Opening
- 10D07Z5 – Extraction of Products of Conception, High Forceps, Via Natural or Artificial Opening
- 10D07Z6 – Extraction of Products of Conception, Vacuum, Via Natural or Artificial Opening
- 10D07Z7 – Extraction of Products of Conception, Internal Version, Via Natural or Artificial Opening
- 10D07Z8 – Extraction of Products of Conception, Other, Via Natural or Artificial Opening
- 10E0XZZ – Delivery of Products of Conception, External Approach
- 10S07ZZ – Reposition Products of Conception, Via Natural or Artificial Opening
Delivery Outcome Secondary Diagnosis Codes:
- Z370 – Single live birth
- Z371 – Single stillbirth
- Z372 – Twins, both liveborn
- Z373 – Twins, one liveborn and one stillborn
- Z374 – Twins, both stillborn
- Z3750 – Multiple births, unspecified, all liveborn
- Z3751 – Triplets, all liveborn
- Z3752 – Quadruplets, all liveborn
- Z3753 – Quintuplets, all liveborn
- Z3754 – Sextuplets, all liveborn
- Z3759 – Other multiple births, all liveborn
- Z3760 – Multiple births, unspecified, some liveborn
- Z3761 – Triplets, some liveborn
- Z3762 – Quadruplets, some liveborn
- Z3763 – Quintuplets, some liveborn
- Z3764 – Sextuplets, some liveborn
- Z3769 – Other multiple births, some liveborn
- Z377 – Other multiple births, all stillborn
- Z379 – Outcome of delivery, unspecified
This final set of conditions encompasses both procedural interventions and outcomes. The inclusion of delivery procedures like forceps or vacuum extractions, along with various multiple birth scenarios, further defines the scope of DRG 774. These conditions recognize that certain delivery methods and outcomes inherently carry a higher degree of complexity and resource utilization.
Importance of Accurate Delivery Diagnosis Codes
Accurate assignment of DRG 774, and by extension, correct utilization of delivery diagnosis codes, is critical for several reasons. Firstly, it ensures appropriate reimbursement for healthcare providers, reflecting the resource intensity associated with managing complicated vaginal deliveries. Secondly, accurate coding contributes to valuable healthcare data, which is used for statistical analysis, healthcare planning, and quality improvement initiatives. Finally, for medical coding professionals, a thorough understanding of DRG 774 and its associated codes is essential for professional competency and accurate claims processing.
In conclusion, DRG 774 for “Vaginal Delivery with Complicating Diagnoses” is a nuanced category within medical coding. It is triggered by a combination of vaginal delivery and the presence of specific complicating diagnoses, delivery procedures, or delivery outcomes. A detailed understanding of the ICD-10 codes associated with each of these conditions is vital for healthcare professionals involved in coding, billing, and healthcare administration. By correctly applying these delivery diagnosis codes, healthcare systems can ensure accurate representation of patient complexity, appropriate reimbursement, and valuable data collection for continuous improvement in maternal healthcare.
