Bacterial vag icd 10

ICD-10 code N76.0 for Acute vaginitis is a medical classification as listed by WHO under the range -Inflammatory diseases of female pelvic organs . Select. Code Sets; ... Vaginal Itchiness ICD-10 [QUOTE="thomas7331, post: 511850, member: 5404"] I would use L29.8 instead of N76.0. Itching can't be classified to N76.0 unless the provider ...

Bacterial vaginosis (BV), also known as vaginal bacteriosis or Gardnerella vaginitis, is a disease of the vagina caused by excessive growth of bacteria. Common symptoms …It appears that infection with bacterial vaginosis in early pregnancy (second trimester) conveys a greater risk for complications than infection with bacterial vaginosis in late pregnancy. 5 ...Labcorp test details for Bacterial Vaginosis (Sialidase), Chlamydia trachomatis, Neisseria ... collect vaginal fluid sample by contacting the lower one-third of the vaginal wall, rotating for 10 to 20 seconds to absorb fluid. Immediately place the swabs into the transport tubes. ... Trich vag by NAA: 46154-1: 182725: BV+Ct/Ng/Tv NAA+Yeast ...ICD-10-CM Diagnosis Code N94.2 [convert to ICD-9-CM] Vaginismus. ICD-10-CM Diagnosis Code N76.89 [convert to ICD-9-CM] Other specified inflammation of vagina and vulva. Nonmenopausal atrophic vaginitis. ICD-10-CM Diagnosis Code A59.01 [convert to ICD-9-CM] Trichomonal vulvovaginitis. Postpartum (after childbirth) trichomonas vaginitis ... 1. Select the Correct Code. Choose the ICD-10 code that best represents the diagnosis. For vaginal itching, the appropriate code might be within the category “N94.89 – Other specified conditions associated with female genital organs and menstrual cycle.”. 2.Vaginitis is defined as any condition with symptoms of abnormal vaginal discharge, odor, irritation, itching, or burning. The most common causes of vaginitis are bacterial vaginosis, vulvovaginal ...

Here’s How to Follow ICD-10 Instruction Under N76. Published on Wed Aug 09, 2023. Question: Code N76 (Other inflammation of vagina and vulva) shows a message in red underneath this code stating: “Use additional code (B95-B97), to identify infectious agent.”. I was told by one of our MDs that these specific bacterial and viral tests are ...Highlights. 2021 STI Treatment Guidelines – Bacterial Vaginosis – Updated diagnostic, treatment, and screening recommendations for STIs. (July 22, 2021) Last Reviewed: July 22, 2021. Source: Division of STD …2546 records ... Results: All female subjects received an ICD-10 psychiatric diagnosis ... PCR for bacterial vaginosis (BV)-associated bacteria was tested by PCR ...The 2024 edition of ICD-10-CM A74.9 became effective on October 1, 2023. This is the American ICD-10-CM version of A74.9 - other international versions of ICD-10 A74.9 may differ. Applicable To. Chlamydiosis NOS. The following code (s) above A74.9 contain annotation back-references that may be applicable to A74.9 :International Classification of Diseases, 10. th. Revision, Clinical Modification (ICD-10-CM). These guidelines should be used as a companion document to the official version of the ICD-10- CM as published on the NCHS website. The ICD-10 …B37.1 Pulmonary candidiasis. B37.2 Candidiasis of skin and nail. B37.3 Candidiasis of vulva and vagina. B37.31 Acute candidiasis of vulva and vagina. B37.32 Chronic candidiasis of vulva and vagina. B37.4 Candidiasis of other urogenital sites. B37.41 Candidal cystitis and urethritis. B37.42 Candidal balanitis.ICD 10 code for Streptococcus, group A, as the cause of diseases classified elsewhere. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code B95.0. Toggle navigation. Search All ICD-10 Toggle Dropdown. Search All ICD …

There is a broad differential, including candidiasis, bacterial vaginosis, trichomoniasis, gonorrhea or chlamydia infection, lichen planus, atrophic vaginitis, desquamative inflammatory vaginitis (DIV), or a less commonly discussed condition, cytolytic vaginosis. Based on her presentation and her wet mount results, a diagnosis of …ICD-10-CM Code for Vaginitis, vulvitis and vulvovaginitis in diseases classified elsewhere N77.1 ICD-10 code N77.1 for Vaginitis, vulvitis and vulvovaginitis in diseases classified elsewhere is a medical classification as listed by WHO under the range - Diseases of the genitourinary system . Source ICD-10-CM Code Target ICD-9-CM Code; N89.8: 623.4 - Old vaginal laceration: Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.: N89.8: 623.5 - Noninfect vag leukorrhea: Approximate Flag - The …N73.2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2023 edition of ICD-10-CM N73.2 became effective on October 1, 2022. This is the American ICD-10-CM version of N73.2 - other international versions of ICD-10 N73.2 may differ. ICD-10-CM Coding Rules.

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Trichomoniasis is a common sexually transmitted infection caused by a parasite. In women, trichomoniasis can cause a foul-smelling vaginal discharge, genital itching and painful urination. Men who have trichomoniasis typically have no symptoms. Pregnant women who have trichomoniasis might be at higher risk of delivering their …Here's what know about four common vaginal infections while pregnant: bacterial vaginosis, yeast infection, group B strep, and trichomoniasis. By Nicole Fabian-Weber. Updated on September 17, 2023 ...Jul 17, 2023 · Candidal vulvovaginitis is caused by inflammatory changes in the vaginal and vulvar epithelium secondary to infection with Candida species, most commonly Candida albicans. Candida is part of the normal flora in many women and is often asymptomatic. Therefore, candidal vulvovaginitis requires both the presence of candida in the vagina/vulva as ... Prolapse vag vault after hysterectomy. 316, N994, Postproc pelvic peritoneal ... bacterial agent is resistant. The code identifying the actual infection will ...

With antibiotics, bacterial vaginosis clears up within three days, according to Cigna. Although symptoms may clear, patients should take the full course of antibiotics that lasts around seven days. Mild cases of bacterial vaginosis may also...Bacterial cholangitis; Cholangitis, bacterial; ... ICD-10-CM Diagnosis Code T50.A22S. Poisoning by mixed bacterial vaccines without a pertussis component, intentional ... Billable Medical Code for Vaginitis and Vulvovaginitis, Unspecified Diagnosis Code for Reimbursement Claim: ICD-9-CM 616.10 Code will be replaced by October 2015 and relabeled as ICD-10-CM 616.10. The Short Description Is: Vaginitis NOS. Known As Bacterial vaginosis is also known as acute vaginitis, acute vulvitis, bacterial vaginosis, …Bacterial vaginosis (BV) is a vaginal infection that is most common in sexually active people assigned female at birth between the ages of 14 and 49. While the exact cause of BV is unknown ...N76.0 is a billable ICD-10 code used to specify a medical diagnosis of acute vaginitis. The code is valid during the fiscal year 2023 from October 01, 2022 through September 30, 2023 for the submission of HIPAA-covered transactions. This code is applicable to female patients only. It is clinically and virtually impossible to use this code on a ...Postmenopausal atrophic vaginitis. N95.2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2024 edition of ICD-10-CM N95.2 became effective on October 1, 2023. This is the American ICD-10-CM version of N95.2 - other international versions of ICD-10 N95.2 may differ.Oct 9, 2019. 3. Photo by Imani Clovis on Unsplash. Bacterial vaginosis (BV) is an imbalance of vaginal bacteria that can cause a foul odor and increased discharge. Women who experience frequent recurrences of BV are not just inconvenienced; they are tormented. It impacts their self-esteem, as well as their health.Jun 10, 2023 · Metronidazole (Flagyl, Metrogel-Vaginal, others). This medicine comes as a pill or topical gel. You swallow the pill, but the gel is inserted into your vagina. Avoid alcohol while using this medicine and for a full day afterward. It might cause nausea or stomach pain. Check the instructions on the product. Clindamycin (Cleocin, Clindesse, others). Collection. Vaginal swab: Collect vaginal fluid sample using the Aptima® swab by contacting the swab to the lower third of the vaginal wall and rotating the swab for 10 to 30 seconds to absorb fluid. Immediately place the swab into the transport tube and carefully break the swab shaft against the side of the tube. Tightly screw on the cap.

Here’s How to Follow ICD-10 Instruction Under N76. Published on Wed Aug 09, 2023. Question: Code N76 (Other inflammation of vagina and vulva) shows a message in red underneath this code stating: “Use additional code (B95-B97), to identify infectious agent.”. I was told by one of our MDs that these specific bacterial and viral tests are ...

Bacterial vaginosis is relatively common and, thankfully, treatable. It’s a mild infection that affects females of various ages. Unfortunately, the cause isn’t entirely understood. It’s important to know that your vagina naturally contains ...The ICD code B96 is used to code Bacterial vaginosis. Bacterial vaginosis (BV), also known as vaginal bacteriosis or Gardnerella vaginitis, is a disease of the vagina caused by excessive growth of bacteria. Common symptoms include increased vaginal discharge that often smells like fish. The discharge is usually white or gray in color.Approximately 10% – 30% of pregnant women will experience bacterial vaginosis (BV) during their pregnancy. BV is characterized by a shift from a healthy vaginal microbiome – one dominated by acid-producing bacteria (the healthy bacteria, such as lactobacillus) – to a vagina dominated by unhealthy bacteria.The most common causes of unpleasant vaginal odor are: Bacterial vaginosis (BV): An infection that’s caused by an imbalance in your vagina’s flora. BV is responsible for the fishy smell most commonly associated with unpleasant vaginal odors. The fishy smell may be especially strong after sex.It's common for bacterial vaginosis to come back within 3 to 12 months even with proper treatment. Researchers are exploring options for recurrent BV. If your …Bacterial vaginosis (BV) is a common vaginal infection that can cause abnormal vaginal discharge color or odor, vaginal itching, or a burning sensation when you urinate (pee). Bacterial vaginosis ...P36 Bacterial sepsis of newborn. P36.0 Sepsis of newborn due to streptococcus, ... ICD-10-CM Diagnosis Code T50.A96S. Underdosing of other bacterial vaccines, sequela. N76.1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2024 edition of ICD-10-CM N76.1 became effective on October 1, 2023. This is the American ICD-10-CM version of N76.1 - other international versions of ICD-10 N76.1 may differ. ICD-10-CM Coding RulesICD-10-CM Diagnosis Code N94.2 [convert to ICD-9-CM] Vaginismus. ICD-10-CM Diagnosis Code N76.89 [convert to ICD-9-CM] Other specified inflammation of vagina and vulva. Nonmenopausal atrophic vaginitis. ICD-10-CM Diagnosis Code A59.01 [convert to ICD-9-CM] Trichomonal vulvovaginitis. Postpartum (after childbirth) trichomonas vaginitis ...

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ICD 10 code for Streptococcus, group A, as the cause of diseases classified elsewhere. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code B95.0. Toggle navigation. Search All ICD-10 Toggle Dropdown. Search All ICD …O23.599 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Short description: Infection oth prt genital tract in pregnancy, unsp trimester The 2024 edition of ICD-10-CM O23.599 became effective on October 1, 2023. Bacterial vaginosis postpartum Desquamative inflammatory vaginitis Postpartum (after childbirth) bacterial vaginosis Vaginitis Vaginitis in pregnancy Vulvovaginitis Vulvovaginitis (inflammation of vulva and vagina)O34.61 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2024 edition of ICD-10-CM O34.61 became effective on October 1, 2023. This is the American ICD-10-CM version of O34.61 - other international versions of ICD-10 O34.61 may differ. ICD-10-CM Coding Rules.10. PCR testing and Multitarget polymerase chain reaction (PCR) testing for diagnosis of bacterial vaginosis DO NOT MEET COVERAGE CRITERIA. 11. Using molecular-based panel testing, including, but not limited to testing such as SmartJane™, to test for microorganisms involved in vaginal flora imbalance and/orSee full list on mayoclinic.org Jul 11, 2022 · The correct ICD-10 code for Bacterial Vaginosis (BV) is N76.0, effective from October 1, 2021, through September 30, 2022. This includes: If using a single ICD9 code, 616.10 is an approximate match for comparison and conversion purposes. Please note that codes vary depending on the patient’s symptoms. Bacterial vaginosis and adverse outcomes among full-term infants: a cohort study ... “Bac Vag”, or “B Vaginosis”). Additional exposed women were identified using ICD-9 codes 616.10, 616.11, and 646.63 from CHARS data. BV-unexposed women did not have a write-in infection that could be identified as BV nor any BV ICD-9 codes in …The Affirm VP III (Becton Dickinson) is an oligonucleotide probe test that detects high concentrations of G. vaginalis nucleic acids (>5 x 10 5 CFU of G. vaginalis/ mL of vaginal fluid) for diagnosing BV, Candida species, and T. vaginalis. This test has been reported to be most useful for symptomatic women in conjunction with vaginal pH ...The 2024 edition of ICD-10-CM Z12.72 became effective on October 1, 2023. This is the American ICD-10-CM version of Z12.72 - other international versions of ICD-10 Z12.72 may differ. Z12.72 is applicable to female patients. Vaginal pap smear status-post hysterectomy for non-malignant condition.N89.8 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2024 edition of ICD-10-CM N89.8 became effective on October 1, 2023. This is the American ICD-10-CM version of N89.8 - other international versions of ICD-10 N89.8 may differ. ICD-10-CM Coding Rules. ….

A49.1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2024 edition of ICD-10-CM A49.1 became effective on October 1, 2023. This is the American ICD-10-CM version of A49.1 - other international versions of ICD-10 A49.1 may differ. Vaginismus ICD-10-CM Diagnosis Code N76.89 [convert to ICD-9-CM] Other specified inflammation of vagina and vulva Nonmenopausal atrophic vaginitis ICD-10-CM Diagnosis Code A59.01 [convert to ICD-9-CM] Trichomonal vulvovaginitisSource ICD-10-CM Code Target ICD-9-CM Code; N89.8: 623.4 - Old vaginal laceration: Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.: N89.8: 623.5 - Noninfect vag leukorrhea: Approximate Flag - The …... vag vault after hysterectomy. N994 Postproc pelvic peritoneal adhesions. N995 ... bacterial diseases. Z11.3. Special screening examination for infections with a ...The following ICD Diagnosis Codes are considered medically necessary when submitted with the CPT codes above if medical necessity criteria are met: ICD-10 Diagnosis Codes ICD-10-CM Diagnosis codes: Code Description B37.31 Acute candidiasis of vulva and vagina B37.32 Chronic candidiasis of vulva and vagina B37.9 Candidiasis, unspecified A vaginal yeast infection is a fungal infection that causes irritation, discharge and intense itchiness of the vagina and the vulva — the tissues at the vaginal opening. Also called vaginal candidiasis, vaginal yeast infection affects up to 3 out of 4 women at some point in their lifetimes. Many women experience at least two episodes.Highlights. 2021 STI Treatment Guidelines – Bacterial Vaginosis – Updated diagnostic, treatment, and screening recommendations for STIs. (July 22, 2021) Last Reviewed: July 22, 2021. Source: Division of STD …Symptoms include pain and purulent discharge. Inflammation of the vulva and the vagina, characterized by discharge, burning, and pruritus. ICD-10-CM N76.0 is grouped within Diagnostic Related Group (s) (MS-DRG v41.0): 742 Uterine and adnexa procedures for … Bacterial vag icd 10, N39.0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2024 edition of ICD-10-CM N39.0 became effective on October 1, 2023. This is the American ICD-10-CM version of N39.0 - other international versions of ICD-10 N39.0 may differ. Use Additional., Summary. Bacterial vaginosis (BV) results from an imbalance in beneficial and harmful bacteria in the vagina. It can cause vaginal itchiness, unusual discharge, and a characteristic odor, among ..., Symptoms include pain and purulent discharge. Inflammation of the vulva and the vagina, characterized by discharge, burning, and pruritus. ICD-10-CM N76.0 is grouped within Diagnostic Related Group (s) (MS-DRG v41.0): 742 Uterine and adnexa procedures for …, Causes of Green Discharge. Sexually transmitted infections are the most common causes of green discharge, but there are others. Green discharge may result from: Trichomoniasis. Gonorrhea. Chlamydia. Bacterial vaginosis. Pelvic inflammatory disease. A foreign object in the vagina., Chlamydial vulvovaginitis. A56.02 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2024 edition of ICD-10-CM A56.02 became effective on October 1, 2023. This is the American ICD-10-CM version of A56.02 - other international versions of ICD-10 A56.02 may differ. , See full list on mayoclinic.org , N89.8 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2024 edition of ICD-10-CM N89.8 became effective on October 1, 2023. This is the American ICD-10-CM version of N89.8 - other international versions of ICD-10 N89.8 may differ. ICD-10-CM Coding Rules. , This is the American ICD-10-CM version of O34.219 - other international versions of ICD-10 O34.219 may differ. ICD-10-CM Coding Rules. O34.219 is applicable to maternity patients aged 12 - 55 years inclusive. O34.219 is applicable to female patients. The following code(s) above O34.219 contain annotation back-references., Your doctor may suggest a topical cream to help soothe any itching or burning. If your vaginitis is caused by an infection, you’ll need the right kind of medicine to treat it. Yeast infections ..., The correct ICD-10 code for Bacterial Vaginosis (BV) is N76.0, effective from October 1, 2021, through September 30, 2022. This includes: If using a single ICD9 code, 616.10 is an approximate match for comparison and conversion purposes. Please note that codes vary depending on the patient’s symptoms., O23.599 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Short description: Infection oth prt genital tract in pregnancy, unsp trimester The 2024 edition of ICD-10-CM O23.599 became effective on October 1, 2023., B37.31 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2024 edition of ICD-10-CM B37.31 became effective on October 1, 2023. This is the American ICD-10-CM version of B37.31 - other international versions of ICD-10 B37.31 may differ. B37.31 is applicable to female patients., Figure. According to the CDC, bacterial vaginosis (BV) is one of the most common vaginal disorders in women ages 14-49. 1 Estimated BV occurrence in women of reproductive age is about 29%. 1-3 In the US alone, BV affects more than 21 million women. 1,3 BV is more common in non-White women, affecting approximately 50% of Black Americans and 32% of Mexican Americans. , Search Results. 196 results found. Showing 1-25: ICD-10-CM Diagnosis Code N76.0 [convert to ICD-9-CM] Acute vaginitis. Bacterial vaginitis in pregnancy; Bacterial …, For patients presenting with atypical clinical features of bacterial vaginosis, the clinician must be aware of the possibility of a coinfection, such as vaginal candidiasis, trichomoniasis, infection with C trachomatis or N gonorrhoeae, HSV infection, or an alternative diagnosis. Provide patients at risk of HIV with HIV counseling and testing., Symptoms include pain and purulent discharge. Inflammation of the vulva and the vagina, characterized by discharge, burning, and pruritus. ICD-10-CM N76.0 is grouped within Diagnostic Related Group (s) (MS-DRG v41.0): 742 Uterine and adnexa procedures for non-malignancy with cc/mcc. , Summary. Bacterial vaginosis (BV) results from an imbalance in beneficial and harmful bacteria in the vagina. It can cause vaginal itchiness, unusual discharge, and a characteristic odor, among ..., ICD-10 Clinical Concepts Series. ICD-10 Clinical Concepts for OB/GYN is a feature of . Road to 10, a CMS online tool built with physician input. ICD-10 With Road to 10, you can: l Build an ICD-10 action plan customized for your practice l lUse interactive case studies to see how your coding selections compare with your peers’ coding, vulvovaginitis in late syphilis ( A52.76) Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes. ICD 10 code for Candidiasis …, The 3 diseases most frequently associated with vaginitis are bacterial vaginosis (BV), caused by an overgrowth of bacteria including Gardnerella vaginalis ..., The 2024 edition of ICD-10-CM Z11.9 became effective on October 1, 2023. This is the American ICD-10-CM version of Z11.9 - other international versions of ICD-10 Z11.9 may differ. The following code(s) above Z11.9 contain annotation back-references , Icd 10 code bv infection https://1up.health/health-data/icd10/id/B349 Webb1 okt. 2022 · Z86.19 is a billable/specific ICD-10-CM code that can be used to ..., Metronidazole (Flagyl, Metrogel-Vaginal, others). This medicine comes as a pill or topical gel. You swallow the pill, but the gel is inserted into your vagina. Avoid alcohol while using this medicine and for a full day afterward. It might cause nausea or stomach pain. Check the instructions on the product. Clindamycin (Cleocin, Clindesse, others)., Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC; 182493: Vaginal Yeast Culture: 18483-8: 182494: Vaginal Yeast Culture: 18483-8, ICD-10 Clinical Concepts Series. ICD-10 Clinical Concepts for OB/GYN is a feature of . Road to 10, a CMS online tool built with physician input. ICD-10 With Road to 10, you can: l Build an ICD-10 action plan customized for your practice l lUse interactive case studies to see how your coding selections compare with your peers’ coding, Bacterial vaginosis is the most common infectious vaginitis Overview of Vaginitis Vaginitis is infectious or noninfectious inflammation of the vaginal mucosa, sometimes with inflammation of the vulva. Symptoms include vaginal discharge, irritation, pruritus, and erythema... read more .The pathogenesis is unclear but involves the overgrowth of …, Cervical lymphadenopathy refers to swelling of the cervical lymph node(s) and encompasses both infectious (e.g., bacterial or viral infections) and noninfectious causes (e.g., malignancy).Inflammatory cervical lymphadenopathy is more specifically referred to as cervical lymphadenitis, but terms may be used synonymously.Cervical …, P36 Bacterial sepsis of newborn. P36.0 Sepsis of newborn due to streptococcus, ... ICD-10-CM Diagnosis Code T50.A96S. Underdosing of other bacterial vaccines, sequela., The following ICD Diagnosis Codes are considered medically necessary when submitted with the CPT codes above if medical necessity criteria are met: ICD-10 Diagnosis Codes ICD-10-CM Diagnosis codes: Code Description B37.31 Acute candidiasis of vulva and vagina B37.32 Chronic candidiasis of vulva and vagina B37.9 Candidiasis, unspecified, Bacterial vaginosis requires treatment with prescription antibiotics, and symptoms usually go away after the full round of medication is completed, according to MayoClinic. Even if a woman takes all the medication prescribed to her, there i..., Test Code: 4446CPT Code(s): 87070, 87075, 87205Clinical Significance: Deep wound/abscess infections are often caused by a mixture of aerobic and anaerobic bacteria.Includes Aerobic culture, Anaerobic culture and Gram stain. If culture is positive, identification will be performed at an additional charge (CPT code(s): 87076 and/or …, Aerobic vaginitis is a form of dysbiosis, a disturbance in the ecology of aerobic micro- organisms that reside in the vaginal microflora (the microbiome ). These microorganisms include: Escherichia coli. Staphylococcus aureus. Coagulase -negative staphylococci (eg, S. epidermidis) Streptococcus agalactiae. Enterococcus faecalis., This is the American ICD-10-CM version of O34.219 - other international versions of ICD-10 O34.219 may differ. ICD-10-CM Coding Rules. O34.219 is applicable to maternity patients aged 12 - 55 years inclusive. O34.219 is applicable to female patients. The following code(s) above O34.219 contain annotation back-references.