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2025 ICD-10-CM code O66.4

Failed trial of labor, unspecified.

Ensure accurate documentation of labor progress is available to justify the diagnosis of failed trial of labor.Refer to the official ICD-10-CM coding guidelines for detailed instructions and specific scenarios.

Modifiers may be applicable depending on the circumstances of the failed trial of labor and the subsequent intervention (e.g., surgical approach, anesthesia type). Consult your payer's specific guidelines.

Medical necessity is established when a reasonable trial of labor is deemed unsuccessful to prevent complications for the mother or the fetus, indicating that the intervention (cesarean section) was clinically necessary for safe delivery.

Obstetrician-gynecologist,Anesthesiologist (if applicable),Other healthcare professionals involved in the management of labor and delivery.

IMPORTANT:Consider other codes within the O66 range (Other obstructed labor) if the cause of failed trial of labor is specified (e.g., O66.0-O66.3 for specific causes of obstructed labor).

In simple words: This code is used when a woman's labor doesn't progress as expected, and a cesarean delivery becomes necessary.This can happen for many reasons, such as the baby being too large or the mother's pelvis not being wide enough.

This code signifies a failed trial of labor, where labor has not progressed adequately despite a reasonable period of time, necessitating intervention such as cesarean section.The lack of progress may stem from various factors including cephalopelvic disproportion, inadequate uterine contractions, or other obstetric complications.

Example 1: A 35-year-old woman at 40 weeks gestation presents in labor.After 12 hours of active labor with inadequate cervical dilation, a diagnosis of failed trial of labor is made, leading to a cesarean delivery., A 28-year-old G1P0 presents at 39 weeks with labor.She progresses to 6cm dilation over 6 hours with minimal descent, no rotation, and concerning fetal heart rate decelerations. This warrants intervention with a cesarean section, and O66.4 is assigned., A 40-year-old woman with a history of previous cesarean birth attempts a vaginal birth after cesarean (VBAC).However, progress stalls at 5 cm for 4 hours, and the decision is made to proceed with repeat cesarean section. O66.4 is used to code the failed trial of labor.

* Detailed prenatal history and risk factors.* Documentation of labor progress, including cervical dilation, effacement, fetal station, fetal heart rate monitoring, and maternal vital signs.* Justification for the diagnosis of failed trial of labor, including specific criteria used for the decision to proceed with a cesarean section.* Operative notes for the cesarean delivery, including surgical findings and complications.

** This code is for use only on maternal records.It should not be used to code on newborn records.Always use additional codes, as applicable, from category Z3A (Weeks of gestation) to specify the week of gestation if known.

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