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O33.9
ICD-10-CM
Cephalopelvic Disproportion

Understanding Cephalopelvic Disproportion (CPD): This resource provides information on CPD, also known as Fetopelvic Disproportion, including clinical documentation, medical coding, and healthcare implications. Learn about diagnosing and managing CPD in obstetrics.

Also known as

CPD
Fetopelvic Disproportion

Diagnosis Snapshot

Key Facts
  • Definition : Baby's head or body is too large to pass through the mother's pelvis.
  • Clinical Signs : Prolonged labor, arrested descent, non-progressive dilation. Imaging confirms disproportion.
  • Common Settings : Labor and delivery, prenatal clinic, obstetrics ultrasound.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC O33.9 Coding
O65.0-O65.9

Cephalopelvic disproportion

Disproportion between fetal head and maternal pelvis.

O32.0-O32.9

Maternal care for disproportion

Care related to disproportionate fetal growth or presentation.

O34.0-O34.9

Maternal care for abnormal pelvis

Care for pelvic deformities impacting childbirth.

O64.0-O64.9

Obstructed labor due to malposition

Labor obstructed by abnormal fetal presentation or position.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the cephalopelvic disproportion due to maternal pelvic abnormality?

  • Yes

    Specify maternal pelvic abnormality

  • No

    Is it due to fetal size/presentation?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Baby's head or body is too large to fit through the mother's pelvis.
Difficult labor due to slow or stopped progress despite adequate contractions.
Abnormal fetal position or presentation prevents passage through the birth canal.

Documentation Best Practices

Documentation Checklist
  • Document maternal pelvic measurements.
  • Document fetal head size/estimated weight.
  • Note trial of labor progress/arrest.
  • Specify clinical findings indicating CPD.
  • ICD-10 code O65.0, O65.1 if documented

Coding and Audit Risks

Common Risks
  • Unspecified CPD Type

    Coding CPD without specifying if it's inlet, midpelvic, or outlet disproportion leads to inaccurate severity and management reflection.

  • Lack of Supporting Documentation

    Missing clinical indicators like pelvimetry, fetal size estimation, and trial of labor results can cause claim denials and compliance issues.

  • Confusion with Malpresentation

    Misdiagnosis of malpresentation as CPD or vice-versa can affect clinical decision-making and reimbursement accuracy.

Mitigation Tips

Best Practices
  • Accurate fetal weight estimation via ultrasound (ICD-10-CM O32.2XX0)
  • Thorough pelvic assessment (clinical documentation improvement)
  • Consider trial of labor (TOL) with strict monitoring (healthcare compliance)
  • Timely cesarean delivery if CPD confirmed for maternalfetal safety (O65.4)
  • Interdisciplinary team discussion (MD, midwife, RN) for optimal care (E/M coding)

Clinical Decision Support

Checklist
  • Verify maternal pelvic adequacy via clinical pelvimetry or imaging.
  • Assess fetal size and presentation with ultrasound or Leopold maneuvers.
  • Check for prolonged labor, arrest of descent, or failed operative vaginal delivery.
  • Consider trial of labor if uncertainty exists, with close monitoring.

Reimbursement and Quality Metrics

Impact Summary
  • Cephalopelvic Disproportion (CPD) Reimbursement: Impacts coding for delivery, potential C-section, impacting DRG assignment and hospital payments.
  • CPD Coding Accuracy: Precise ICD-10-CM (O65.1) coding crucial for accurate reimbursement and quality data reporting. Avoid O34.5 for solely fetal causes.
  • Hospital Reporting: CPD impacts metrics like C-section rates, postpartum hemorrhage, influencing quality scores and public reporting data.
  • Quality Metrics Impact: CPD influences perinatal outcomes data, potentially affecting hospital quality rankings and value-based payment programs.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Frequently Asked Questions

Common Questions and Answers

Q: How can I accurately diagnose cephalopelvic disproportion (CPD) during labor and delivery, differentiating it from malposition or other causes of dystocia?

A: Accurately diagnosing cephalopelvic disproportion (CPD), also known as fetopelvic disproportion, during labor requires a comprehensive assessment. This includes evaluating the maternal pelvis through clinical pelvimetry, though its predictive value is debated, and imaging techniques like CT or MRI when feasible. Fetal size estimation via ultrasound is crucial, but inherent inaccuracies exist. Crucially, CPD is a diagnosis of exclusion made only after adequate uterine activity and excluding fetal malposition as contributing factors to dystocia. A trial of labor, with careful monitoring of descent and fetal well-being, can help confirm the diagnosis. Consider implementing standardized protocols for dystocia management to ensure consistent and accurate CPD diagnosis. Explore how integrating modern imaging modalities can improve the precision of fetal and pelvic assessments in suspected CPD cases.

Q: What are the evidence-based management options for cephalopelvic disproportion (CPD) diagnosed during labor, considering both maternal and fetal risks?

A: Management of cephalopelvic disproportion (CPD) once diagnosed during labor prioritizes safe delivery. If vaginal delivery is not feasible or safe, a cesarean section is indicated. Prior to labor, if CPD is suspected based on clinical or imaging findings, a planned cesarean delivery may be discussed with the patient. The decision must consider maternal and fetal risks, weighing potential complications of operative delivery against the risks of obstructed labor. Learn more about the risks and benefits of different delivery modes in suspected CPD cases and consider incorporating patient-centered decision-making tools to guide management strategies. Explore current guidelines on the management of labor dystocia and the role of trial of labor in confirming CPD.

Quick Tips

Practical Coding Tips
  • Code O65.1 for CPD in ICD-10
  • Document pelvic and fetal dimensions
  • Specify if due to maternal pelvis
  • Query physician if CPD is suspected
  • Consider Z3A.30 for suspected CPD

Documentation Templates

Patient presents with suspected cephalopelvic disproportion (CPD), also known as fetopelvic disproportion, a pregnancy complication where the fetal head size is too large relative to the maternal pelvic dimensions.  Assessment includes clinical pelvimetry, ultrasound fetal biometry to estimate fetal weight and head circumference, and review of obstetric history including prior deliveries.  Differential diagnoses considered include macrosomia, malpresentation, and contracted pelvis.  Patient reports  labor dystocia with prolonged first and second stages of labor despite adequate uterine contractions.  Vaginal delivery may be challenging or impossible due to the CPD.  Risks associated with CPD include prolonged labor, obstructed labor, uterine rupture, and fetal distress.  Management options are being discussed, including trial of labor versus planned cesarean section.  Fetal monitoring will be continued to assess fetal well-being.  Maternal-fetal risks and benefits of each delivery method have been explained, and informed consent will be obtained.  Current plan includes close monitoring and further evaluation to determine the optimal mode of delivery.
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