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ICD-10 Guide
ICD-10 CodesN82.4

N82.4

Billable

Other female intestinal-genital tract fistulae

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

Code Description

ICD-10 N82.4 is a billable code used to indicate a diagnosis of other female intestinal-genital tract fistulae.

Key Diagnostic Point:

N82.4 refers to other types of fistulae that occur between the female genital tract and the intestinal tract. These fistulae can arise from various conditions, including endometriosis, which can lead to the formation of abnormal connections between the uterus and the intestines. Female genital prolapse may also contribute to the development of fistulae due to the displacement of pelvic organs, which can create pressure and lead to tissue breakdown. Ovarian disorders, such as ovarian cysts or tumors, can also result in fistulous connections if they erode into adjacent structures. Additionally, polyps in the female genital tract may cause obstruction or inflammation, potentially leading to fistula formation. The clinical presentation of these fistulae can vary, including symptoms such as abnormal vaginal discharge, fecal incontinence, or pelvic pain. Diagnosis typically involves imaging studies and clinical evaluation to determine the extent and nature of the fistula, as well as the underlying conditions contributing to its formation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying conditions leading to fistulae
  • Need for detailed documentation of associated diagnoses
  • Potential for multiple fistula types complicating coding
  • Variability in clinical presentation and symptoms

Audit Risk Factors

  • Inadequate documentation of the underlying condition
  • Failure to specify the type of fistula
  • Misclassification of fistula type
  • Lack of imaging or surgical reports to support diagnosis

Specialty Focus

Medical Specialties

Gynecology

Documentation Requirements

Detailed clinical notes on the patient's history, examination findings, and imaging results are essential.

Common Clinical Scenarios

Management of endometriosis-related fistulae, evaluation of pelvic organ prolapse, and treatment of ovarian cysts.

Billing Considerations

Ensure that all relevant gynecological conditions are documented to support the diagnosis of N82.4.

Gastroenterology

Documentation Requirements

Documentation of gastrointestinal evaluations, imaging studies, and surgical interventions is critical.

Common Clinical Scenarios

Assessment of fistulae resulting from inflammatory bowel disease or surgical complications.

Billing Considerations

Collaboration with gynecologists may be necessary for comprehensive management.

Coding Guidelines

Inclusion Criteria

Use N82.4 When
  • According to ICD
  • 10 coding guidelines, N82
  • 4 should be used when the specific type of intestinal
  • genital tract fistula is not classified elsewhere
  • Coders must ensure that the underlying conditions contributing to the fistula are also documented and coded appropriately

Exclusion Criteria

Do NOT use N82.4 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

58661CPT Code

Laparoscopic excision of endometriosis

Clinical Scenario

Used when treating endometriosis that may lead to fistula formation.

Documentation Requirements

Operative reports detailing the extent of endometriosis and any fistula repair performed.

Specialty Considerations

Gynecologists should ensure comprehensive documentation of findings and procedures.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like N82.4, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of outcomes related to complex conditions such as fistulae.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like N82.4, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of outcomes related to complex conditions such as fistulae.

Reimbursement & Billing Impact

reimbursement processes. It has also facilitated better tracking of outcomes related to complex conditions such as fistulae.

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 causes of intestinal-genital tract fistulae?

Common causes include endometriosis, pelvic inflammatory disease, surgical complications, and malignancies affecting the reproductive or gastrointestinal tracts.

How can I ensure accurate coding for N82.4?

Accurate coding requires thorough documentation of the patient's clinical history, imaging results, and any associated conditions that may contribute to the fistula.