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v1.0.0
ICD-10 Guide
ICD-10 CodesN81.8

N81.8

Billable

Other female genital prolapse

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/18/2025

Code Description

ICD-10 N81.8 is a billable code used to indicate a diagnosis of other female genital prolapse.

Key Diagnostic Point:

Other female genital prolapse refers to a condition where there is a descent of the pelvic organs, specifically the uterus, vagina, or other structures, that does not fall under the more commonly classified types of prolapse such as cystocele or rectocele. This condition can arise due to various factors including childbirth, aging, hormonal changes, and connective tissue disorders. It may also be associated with other gynecological conditions such as endometriosis, which can lead to pelvic pain and further complicate the clinical picture. Patients may present with symptoms such as a feeling of heaviness in the pelvic area, urinary incontinence, or difficulty with bowel movements. The presence of fistulas, ovarian disorders, or polyps in the female genital tract can further complicate the diagnosis and management of prolapse. Accurate coding is essential for appropriate treatment planning and reimbursement, as well as for tracking the prevalence and outcomes of this condition in the female population.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of associated conditions (e.g., endometriosis, fistulas)
  • Differentiation from other types of prolapse
  • Potential for overlapping symptoms with other gynecological disorders
  • Need for comprehensive documentation to support diagnosis

Audit Risk Factors

  • Insufficient documentation of associated conditions
  • Inconsistent use of terminology in clinical notes
  • Failure to specify the type of prolapse
  • Lack of clear treatment plans in medical records

Specialty Focus

Medical Specialties

Gynecology

Documentation Requirements

Detailed patient history, physical examination findings, and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with pelvic pain, urinary incontinence, or a palpable mass in the vaginal canal.

Billing Considerations

Documentation should clearly differentiate between types of prolapse and associated conditions.

Urology

Documentation Requirements

Urodynamic studies and assessments of urinary function should be included.

Common Clinical Scenarios

Patients with urinary symptoms that may be related to pelvic organ prolapse.

Billing Considerations

Collaboration with gynecologists for comprehensive management of prolapse-related urinary issues.

Coding Guidelines

Inclusion Criteria

Use N81.8 When
  • According to ICD
  • 10 guidelines, N81
  • 8 should be used when the specific type of female genital prolapse is not classified elsewhere
  • Coders must ensure that the documentation supports the diagnosis and that all relevant conditions are noted

Exclusion Criteria

Do NOT use N81.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

57260CPT Code

Repair of vaginal prolapse

Clinical Scenario

Used when surgical intervention is required for prolapse repair.

Documentation Requirements

Operative reports must detail the procedure performed and the diagnosis.

Specialty Considerations

Gynecologists typically perform these procedures, and documentation should reflect the surgical approach.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of female genital prolapse, enabling better tracking of patient outcomes and more accurate reimbursement for providers.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of female genital prolapse, enabling better tracking of patient outcomes and more accurate reimbursement for providers.

Reimbursement & Billing Impact

reimbursement for providers.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the common symptoms of other female genital prolapse?

Common symptoms include pelvic pressure, urinary incontinence, difficulty with bowel movements, and a sensation of a bulge in the vaginal area.

How is other female genital prolapse diagnosed?

Diagnosis typically involves a pelvic examination, patient history, and may include imaging studies to assess the extent of prolapse.