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v1.0.0
ICD-10 Guide
DiagnosesPelvic Prolapse

Pelvic Prolapse

ICD-10 Coding for Pelvic Prolapse(N81.3, N81.11, N81.6)

PRIMARY SPECIALTYGynecology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Pelvic Prolapse?
Essential facts and insights about Pelvic Prolapse

Key Clinical Considerations:

  • Pelvic pressure or heaviness
  • Urinary incontinence or urgency
  • Bowel dysfunction
  • Visible or palpable bulge in the vagina
  • Sexual dysfunction

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history including symptoms and duration
  • Physical examination findings
  • Results of diagnostic imaging or tests
  • Assessment of severity and impact on quality of life

Coding Guidelines

Usage Guidelines & Examples

  • Ensure correct code selection based on specific prolapse type.
  • Common errors include using unspecified codes or failing to document severity.

Code Exclusions

Important Exclusions

  • Pregnancy-related pelvic conditions
  • Other pelvic floor disorders not classified as prolapse

Related ICD-10 Codes

Primary Codes
N81.0
Cystocele
N81.1
Rectocele
N81.2
Uterine prolapse
N81.3
Vaginal vault prolapse
Ancillary Codes
N99.3
Differential Codes
N81.11
N81.11
for isolated anterior vaginal wall prolapse.
N81.3
N81.3
includes cystocele if complete prolapse is present.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Gynecology

Specialty Applications

  • Women of all ages, particularly postmenopausal women
  • Gynecological clinics, urology departments, and pelvic floor specialty centers

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What are the documentation requirements?

Document patient symptoms, physical exam findings, and any imaging results.

What are the billing considerations?

Ensure accurate coding based on specific type of prolapse and associated symptoms.