11. COMPLICATIONS OF PREGNANCY, CHILDBIRTH, AND THE PUERPERIUM (630-679)
NORMAL DELIVERY, AND OTHER INDICATIONS FOR CARE IN PREGNANCY, LABOR, AND DELIVERY (650-659)
The following fifth-digit subclassification is for use with categories 651-659 to denote the current episode of care:
0 unspecified as to episode of care or not applicable
1 delivered, with or without mention of antepartum condition
2 delivered, with mention of postpartum complication
3 antepartum condition or complication
4 postpartum condition or complication
650: Normal delivery
Delivery requiring minimal or no assistance, with or without episiotomy, without fetal manipulation [e.g., rotation version] or instrumentation [forceps] of a spontaneous, cephalic, vaginal, full-term, single, live-born infant. This code is for use as a single diagnosis code and is not to be used with any other code in the range 630-676.
Use additional code to indicate outcome of delivery (V27.0)
Excludes:
breech delivery (assisted) (spontaneous) NOS (652.2)
delivery by vacuum extractor, forceps, cesarean section, or breech extraction, without specified complication (669.5-669.7)
651: Multiple gestation
Requires fifth digit; valid digits are in [brackets] under each code. see beginning of section 650-659 for definitions.
Use additional code to specify placenta status (V91.00-V91.99)
Excludes:
fetal conjoined twins (678.1)
652: Malposition and malpresentation of fetus
Requires fifth digit; valid digits are in [brackets] under each code. see beginning of section 650-659 for definitions.
Code first any associated obstructed labor (660.0)
653: Disproportion
Requires fifth digit; valid digits are in [brackets] under each code. see beginning of section 650-659 for definitions.
Code first any associated obstructed labor (660.1)
654: Abnormality of organs and soft tissues of pelvis
Requires fifth digit; valid digits are in [brackets] under each code. see beginning of section 650-659 for definitions.
Includes:
the listed conditions during pregnancy, childbirth, or the puerperium
Code first any associated obstructed labor (660.2)
Excludes:
trauma to perineum and vulva complicating current delivery (664.0-664.9)
655: Known or suspected fetal abnormality affecting management of mother
Requires fifth digit; valid digits are in [brackets] under each code. see beginning of section 650-659 for definitions.
Includes:
the listed conditions in the fetus as a reason for observation or obstetrical care of the mother, or for termination of pregnancy
656: Other known or suspected fetal and placental problems affecting management of mother
Requires fifth digit; valid digits are in [brackets] under each code. see beginning of section 650-659 for definitions.
Excludes:
fetal hematologic conditions (678.0)
suspected placental problems not found (V89.02)
657: Polyhydramnios
[0,1,3]
Hydramnios
Requires fifth digit; valid digits are in [brackets] under each code. see beginning of section 650-659 for definitions.
Use 0 as fourth digit for category 657
Excludes:
suspected polyhydramnios not found (V89.01)
658: Other problems associated with amniotic cavity and membranes
Requires fifth digit; valid digits are in [brackets] under each code. see beginning of section 650-659 for definitions.
Excludes:
amniotic fluid embolism (673.1)
suspected problems with amniotic cavity and membranes not found (V89.01)
659: Other indications for care or intervention related to labor and delivery, not elsewhere classified
Requires fifth digit; valid digits are in [brackets] under each code. see beginning of section 650-659 for definitions.

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