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ICD-10 Guide
ICD-10 CodesN76.4

N76.4

Billable

Abscess of vulva

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

Code Description

ICD-10 N76.4 is a billable code used to indicate a diagnosis of abscess of vulva.

Key Diagnostic Point:

An abscess of the vulva is a localized collection of pus within the vulvar tissues, often resulting from bacterial infection. This condition can arise from various causes, including obstruction of the Bartholin's glands, which are located bilaterally at the vaginal opening and are responsible for secreting mucus to lubricate the vagina. When these glands become blocked, fluid accumulates, leading to cyst formation, which can subsequently become infected and develop into an abscess. Symptoms typically include localized pain, swelling, redness, and tenderness in the vulvar area, and may be accompanied by fever or malaise in more severe cases. Diagnosis is primarily clinical, based on physical examination and patient history. Treatment often involves incision and drainage of the abscess, along with antibiotic therapy to address the underlying infection. In cases of recurrent abscesses, further evaluation may be necessary to rule out underlying conditions such as vulvovaginitis or other inflammatory disorders of the female genital tract. Proper coding of this condition is essential for accurate billing and to ensure appropriate management of the patient's health care needs.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between abscess types (e.g., Bartholin's gland vs. other vulvar abscesses)
  • Understanding the relationship with other vulvar conditions (e.g., vulvovaginitis)
  • Documentation of symptoms and treatment plans
  • Potential for recurrent conditions requiring additional coding

Audit Risk Factors

  • Inadequate documentation of the abscess's size and location
  • Failure to document the treatment provided (e.g., drainage procedure)
  • Misclassification of the abscess type
  • Lack of follow-up documentation for recurrent cases

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed clinical notes on the examination findings, treatment provided, and follow-up care.

Common Clinical Scenarios

Management of Bartholin's gland cysts, abscess drainage procedures, and treatment of vulvovaginitis.

Billing Considerations

Ensure accurate documentation of the abscess's characteristics and any associated symptoms to support the diagnosis.

Family Medicine

Documentation Requirements

Comprehensive patient history, physical examination findings, and treatment plans.

Common Clinical Scenarios

Initial evaluation of vulvar pain, referral for surgical intervention, and management of recurrent infections.

Billing Considerations

Document any relevant sexual history or risk factors that may contribute to vulvar infections.

Coding Guidelines

Inclusion Criteria

Use N76.4 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the abscess's characteristics and any associated conditions
  • Include relevant clinical findings and treatment details to support the diagnosis

Exclusion Criteria

Do NOT use N76.4 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

10060CPT Code

Incision and drainage of abscess

Clinical Scenario

Used when performing drainage of a vulvar abscess.

Documentation Requirements

Document the size, location, and nature of the abscess, as well as the procedure performed.

Specialty Considerations

Obstetricians and gynecologists should ensure that the procedure is well-documented to support the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

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

Reimbursement & Billing Impact

reimbursement processes.

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 vulvar abscesses?

Common causes include obstruction of Bartholin's glands, bacterial infections, and trauma to the vulvar area.

How is a vulvar abscess diagnosed?

Diagnosis is primarily clinical, based on physical examination findings and patient history, often confirmed by the presence of purulent discharge.

What treatments are available for vulvar abscesses?

Treatment typically involves incision and drainage of the abscess, along with antibiotic therapy to address any underlying infection.