Obstructed labor due to shoulder presentation, fetus 4

This code signifies a complicated labor where the baby's shoulder is presenting first, preventing a normal vaginal delivery. This malpresentation leads to an obstruction, requiring intervention to safely deliver the fetus. The "4" in the seventh character indicates that this is the fourth fetus in a multiple gestation pregnancy.

Assign this code when documentation clearly indicates obstructed labor specifically due to a shoulder presentation. This typically occurs when the fetal lie is transverse or oblique. Supporting documentation includes physician notes detailing the malpresentation, the resulting labor dystocia, and the identification of the fourth fetus in a multiple gestation.

• Ensure the documentation specifies "shoulder presentation" as the cause of obstruction, not another type of malpresentation.
• Verify that the patient is experiencing a multiple gestation and that the obstructed fetus is indeed the fourth one.
• Always sequence this code as a principal diagnosis when it is the primary reason for the encounter, followed by codes for the outcome of delivery and other relevant conditions.