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ICD-10 Guide
ICD-10 CodesN83.40

N83.40

Billable

Prolapse and hernia of ovary and fallopian tube, unspecified side

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

Code Description

ICD-10 N83.40 is a billable code used to indicate a diagnosis of prolapse and hernia of ovary and fallopian tube, unspecified side.

Key Diagnostic Point:

Prolapse and hernia of the ovary and fallopian tube refers to the abnormal displacement of these structures from their normal anatomical position. This condition can occur due to various factors, including weakened pelvic support structures, trauma, or surgical complications. In women, the prolapse of the ovary and fallopian tube can lead to significant discomfort, pain, and complications such as obstruction or strangulation of the affected structures. The unspecified side indicates that the documentation does not specify whether the left or right ovary and fallopian tube are involved. This condition may be associated with other gynecological disorders, including endometriosis, where endometrial tissue grows outside the uterus, potentially affecting the ovaries and fallopian tubes. Additionally, pelvic organ prolapse, which involves the descent of pelvic organs due to weakened pelvic support, can coexist with this condition. Accurate diagnosis often requires imaging studies and a thorough clinical evaluation to differentiate it from other conditions such as ovarian cysts, tumors, or pelvic inflammatory disease.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified side complicates coding and may require additional documentation.
  • Differentiation from other gynecological conditions can be challenging.
  • Potential for coexisting conditions such as endometriosis or pelvic organ prolapse.
  • Variability in clinical presentation and symptoms.

Audit Risk Factors

  • Insufficient documentation of the condition's specifics.
  • Lack of clarity regarding the side affected.
  • Inadequate differentiation from similar conditions.
  • Failure to document associated symptoms or complications.

Specialty Focus

Medical Specialties

Gynecology

Documentation Requirements

Detailed clinical notes describing the patient's symptoms, physical examination findings, and imaging results.

Common Clinical Scenarios

Patients presenting with pelvic pain, abnormal vaginal discharge, or a palpable mass in the pelvic region.

Billing Considerations

Ensure that the documentation specifies whether the prolapse is symptomatic and any associated conditions such as endometriosis.

Urology

Documentation Requirements

Comprehensive evaluation of urinary symptoms and pelvic support structures.

Common Clinical Scenarios

Patients with urinary incontinence or obstructive urinary symptoms related to pelvic organ prolapse.

Billing Considerations

Coordination with gynecological assessments to ensure comprehensive care.

Coding Guidelines

Inclusion Criteria

Use N83.40 When
  • According to ICD
  • 10 guidelines, this code should be used when the specific side of the prolapse or hernia is not documented
  • Coders should ensure that all relevant clinical information is captured to support the diagnosis
  • If the side becomes known later, a more specific code should be used

Exclusion Criteria

Do NOT use N83.40 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

58661CPT Code

Laparoscopy, surgical, with removal of ovarian cyst

Clinical Scenario

Used when a patient with a prolapse also has an ovarian cyst requiring surgical intervention.

Documentation Requirements

Document the indication for surgery, including the presence of prolapse and cyst.

Specialty Considerations

Ensure coordination between gynecology and surgical teams.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specificity in coding, which can improve the accuracy of diagnoses and treatment plans. However, the introduction of unspecified codes like N83.40 can lead to increased scrutiny during audits if not properly documented.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specificity in coding, which can improve the accuracy of diagnoses and treatment plans. However, the introduction of unspecified codes like N83.40 can lead to increased scrutiny during audits if not properly documented.

Reimbursement & Billing Impact

reimbursement.

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 should I document to support the use of N83.40?

Document the patient's symptoms, physical examination findings, imaging results, and any associated conditions. Ensure clarity regarding the unspecified side.