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v1.0.0
ICD-10 Guide
ICD-10 CodesQ52.0

Q52.0

Billable

Congenital absence of vagina

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 Q52.0 is a billable code used to indicate a diagnosis of congenital absence of vagina.

Key Diagnostic Point:

Congenital absence of the vagina, also known as vaginal agenesis, is a rare condition that occurs when the vagina fails to develop properly during fetal development. This condition is often associated with other congenital anomalies, particularly those affecting the reproductive system. In females, the absence of the vagina can lead to significant psychosocial and physical challenges, including difficulties with menstruation and sexual intercourse. It is frequently linked with other malformations such as Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, which may also involve renal anomalies and uterine malformations. Diagnosis is typically made through physical examination and imaging studies, such as ultrasound or MRI, which can help assess the presence of other reproductive structures. Treatment often involves surgical intervention to create a neovagina, along with psychological support to address the emotional aspects of the condition. Understanding the complexities of this condition is crucial for accurate coding and management in pediatric and genetic settings.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in associated congenital anomalies
  • Need for multidisciplinary care coordination
  • Potential for psychological impact and counseling
  • Differentiation from other genital malformations

Audit Risk Factors

  • Inadequate documentation of associated anomalies
  • Failure to capture the complexity of the condition
  • Misclassification with other genital malformations
  • Lack of evidence for surgical interventions

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed documentation of physical examination findings, imaging results, and any associated congenital anomalies.

Common Clinical Scenarios

Evaluation of newborns with ambiguous genitalia, assessment of adolescents with delayed menarche, and management of patients undergoing surgical reconstruction.

Billing Considerations

Consideration of the psychosocial impact on the patient and family, as well as the need for ongoing follow-up and support.

Genetics

Documentation Requirements

Genetic testing results, family history of congenital conditions, and any syndromic associations.

Common Clinical Scenarios

Genetic counseling for families with a history of congenital malformations, evaluation of patients with MRKH syndrome, and assessment of chromosomal abnormalities.

Billing Considerations

Understanding the genetic basis of congenital absence of vagina and its potential syndromic associations.

Coding Guidelines

Inclusion Criteria

Use Q52.0 When
  • Follow the official ICD
  • CM guidelines for coding congenital conditions, ensuring accurate documentation of associated anomalies and any surgical interventions performed

Exclusion Criteria

Do NOT use Q52.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

58150CPT Code

Vaginoplasty

Clinical Scenario

Performed for patients with congenital absence of vagina to create a neovagina.

Documentation Requirements

Detailed operative report and pre-operative assessments.

Specialty Considerations

Consideration of psychological support and counseling pre- and post-surgery.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    Congenital Anomalies: A Guide for Clinicians

Coding & Billing References

  • •
    Congenital Anomalies: A Guide for Clinicians

Frequently Asked Questions

What are the common associated conditions with congenital absence of vagina?

Common associated conditions include renal anomalies, uterine malformations, and syndromic presentations such as MRKH syndrome. Accurate documentation of these conditions is essential for proper coding and management.