O34.218 ICD-10-CM Code: Maternal care for other type scar from previous cesarean delivery
HCC Buddy Code Card
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FY 2026 Apr update / Pregnancy, childbirth and the puerperium (O00-O9A) / Maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)
O34.218
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceMaternal care for other type scar from previous cesarean delivery
Pregnant patient with a cesarean scar of a type other than vertical (such as classical or low transverse), requiring monitoring during pregnancy.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
Official- Mid-transverse T incision
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for O34.218 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for O34.218 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for O34.218 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for O34.218 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for O34.218 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for O34.218 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is O34.218 an HCC code?
No. O34.218 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
O34.218 is the ICD-10-CM diagnosis code for maternal care for other type scar from previous cesarean delivery. Pregnant patient with a cesarean scar of a type other than vertical (such as classical or low transverse), requiring monitoring during pregnancy. O34.218 sits in the ICD-10-CM chapter for pregnancy, childbirth and the puerperium (o00-o9a), within the section covering maternal care related to the fetus and amniotic cavity and possible delivery problems (o30-o48).
O34.218 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Use this code when scar type is documented but does not fit vertical or isthmocele categories.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O34.218 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code when scar type is documented but does not fit vertical or isthmocele categories
- •Requires trimester specification with 5th character for complete coding