Third degree perineal laceration during delivery, IIIc

This code signifies a severe obstetric laceration involving the perineum that extends through the anal sphincter complex, including both the external and internal anal sphincters, occurring during the process of childbirth. This type of injury can lead to significant morbidity, including fecal incontinence.

Apply this code when documentation explicitly states a third-degree perineal laceration occurred during delivery, specifically identifying involvement of the internal anal sphincter (IIIc). This diagnosis is typically made by the delivering clinician and documented in the delivery notes or operative report.

• Ensure the documentation clearly specifies involvement of the internal anal sphincter to differentiate from other third-degree laceration subtypes.
• Do not confuse with O70.21 (IIIa) or O70.22 (IIIb), which involve only the external anal sphincter or less than 50% of the external anal sphincter, respectively.
• Always sequence this code after the primary delivery code (e.g., O80, O82) if it's a complication of the delivery.