Appendix A1: Primary Term Singleton Vertex
Cesarean Delivery Rate
(WSHA Roadmap Measure)
Measure and Code Specifications
DRAFT – based on AHRQ DRAFT Measure Specifications
for IQI 33 Primary Cesarean Delivery Rate– Uncomplicated
(v. 5.0) with WSHA Roadmap addition of Gestational Age at
Delivery < 37 weeks to Exclusion list
These measure specifications will be updated when AHRQ
finalizes the specifications code list.
Description
First-time Cesarean deliveries without a hysterotomy procedure per 100 deliveries. Excludes deliveries with
abnormal presentation, preterm delivery < 37 weeks gestational age at delivery, fetal death, and multiple
gestation diagnoses.
Numerator
Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with either:
• DRG or MS-DRG or ICD-10 procedure codes for Cesarean delivery; or
• any-listed ICD-10 procedure codes for Cesarean delivery without any-listed ICD-10 procedure code for
hysterotomy
Include: Cesarean Delivery Procedure Codes ICD-10-PCS
10D00Z0
10C00Z1
10D00Z2
Extraction of Products of Conception, Classical, Open Approach
Extraction of Products of Conception, Low Cervical, Open Approach
Extraction of Products of Conception, Extraperitoneal, Open Approach
Exclude: Hysterotomy Procedure Codes ICD-10-PCS
10A00ZZ
10A03ZZ
10Z04ZZ
Abortion of Products of Conception, Open Approach
Abortion of Products of Conception, Percutaneous Approach
Abortion of Products of Conception, Percutaneous Endoscopic Approach
Denominator
- INCLUDE all deliveries, identified by DRG, MS-DRG or ICD-10-CM codes
ICD-10-CM Delivery Codes
From Joint Commission Appendix A Table 11.01.1 Delivery Codes
Code
Shortened Description
10D00Z0
Extraction of Products of Conception, Classical, Open Approach
10D00Z1
Extraction of Products of Conception, Low Cervical, Open Approach
10D00Z2
Extraction of Products of Conception, Extraperitoneal, Open Approach
10D07Z3
Extraction of Products of Conception, Low Forceps, Via Natural or Artificial Opening
10D07Z4
Extraction of Products of Conception, Mid Forceps, Via Natural or Artificial Opening
10D07Z5
Extraction of Products of Conception, High Forceps, Via Natural or Artificial Opening
Code
Shortened Description
10D07Z6
Extraction of Products of Conception, Vacuum, Via Natural or Artificial Opening
10D07Z7
Extraction of Products of Conception, Internal Version, Via Natural or Artificial Opening
10D07Z8
Extraction of Products of Conception, Other, Via Natural or Artificial Opening
10E0XZZ
Delivery of Products of Conception, External Approach
EXCLUDE deliveries:



With gestational age at delivery < 37 weeks (found in supplemental perinatal data)
With any listed ICD-10-CM diagnosis code for previous Cesarean delivery: 03421 (Maternal care for scar
from previous cesarean delivery), 06641 (Failed attempted vaginal birth after previous cesarean
delivery)
With any of ICD-10-CM diagnosis codes for AHRQ Contraindications to Vaginal Delivery diagnosis
(abnormal presentation, preterm, fetal death, or multiple gestation, found in Primary TSV C-section IQI
33 Appendix A)
NOTE: When Washington State birth certificate data is available add to exclusions: “History of previous
cesarean delivery “ (field #57.7 on WA State Birth Filing Form)
Url for AHRQ Inpatient Quality Indicators website:
http://www.qualityindicators.ahrq.gov/Modules/IQI_TechSp
ec_ICD10.aspx