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v1.0.0
ICD-10 Guide
ICD-10 CodesN82.5

N82.5

Billable

Female genital tract-skin fistulae

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

Code Description

ICD-10 N82.5 is a billable code used to indicate a diagnosis of female genital tract-skin fistulae.

Key Diagnostic Point:

Female genital tract-skin fistulae refer to abnormal connections between the female genital tract and the skin, often resulting from various underlying conditions such as endometriosis, female genital prolapse, or surgical complications. These fistulae can lead to significant morbidity, including chronic pain, infection, and social stigma due to incontinence or odor. Endometriosis, characterized by the presence of endometrial-like tissue outside the uterus, can cause adhesions and subsequent fistula formation. Female genital prolapse may also contribute to fistula development, particularly in cases where tissue integrity is compromised. Additionally, fistulas can arise from ovarian disorders, such as cysts or tumors, that erode into adjacent structures. Polyps in the female genital tract, while less commonly associated with fistulae, can also contribute to abnormal connections if they lead to tissue necrosis or ulceration. Accurate diagnosis and management of these conditions are crucial to prevent complications and improve the quality of life for affected individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying conditions leading to fistulae
  • Need for detailed documentation of surgical history
  • Potential for multiple co-existing diagnoses
  • Variability in clinical presentation and symptoms

Audit Risk Factors

  • Inadequate documentation of the underlying cause
  • Failure to specify the type of fistula
  • Lack of clarity in surgical history
  • Misclassification of related conditions

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed surgical history, descriptions of the fistula, and associated conditions must be documented.

Common Clinical Scenarios

Management of endometriosis-related fistulae, repair of prolapse-related fistulae.

Billing Considerations

Ensure that all relevant diagnostic tests and imaging studies are included in the documentation.

Urology

Documentation Requirements

Comprehensive assessment of urinary function and any surgical interventions performed.

Common Clinical Scenarios

Evaluation and repair of urethrovaginal or vesicovaginal fistulae.

Billing Considerations

Collaboration with gynecologists may be necessary for complex cases.

Coding Guidelines

Inclusion Criteria

Use N82.5 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the fistula type and underlying conditions
  • Include any relevant surgical history and associated diagnoses to support the coding

Exclusion Criteria

Do NOT use N82.5 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

58661CPT Code

Laparoscopic excision of endometriosis

Clinical Scenario

Used when endometriosis is the underlying cause of the fistula.

Documentation Requirements

Document the extent of endometriosis and any associated procedures performed.

Specialty Considerations

Collaboration with gynecology for comprehensive care.

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 female genital tract-skin fistulae, improving the accuracy of data collection and reimbursement processes. This specificity aids in better understanding the epidemiology and treatment outcomes of these conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like female genital tract-skin fistulae, improving the accuracy of data collection and reimbursement processes. This specificity aids in better understanding the epidemiology and treatment outcomes of these conditions.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better understanding the epidemiology and treatment outcomes of these conditions.

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 female genital tract-skin fistulae?

Common causes include endometriosis, female genital prolapse, surgical complications, and malignancies affecting the reproductive organs.