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ICD-10 Guide
ICD-10 CodesN81.84

N81.84

Billable

Pelvic muscle wasting

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

Code Description

ICD-10 N81.84 is a billable code used to indicate a diagnosis of pelvic muscle wasting.

Key Diagnostic Point:

Pelvic muscle wasting refers to the atrophy or weakening of the pelvic floor muscles, which can significantly impact a woman's quality of life. This condition is often associated with various gynecological disorders, including endometriosis, female genital prolapse, fistulas, ovarian disorders, and polyps of the female genital tract. Endometriosis can lead to chronic pelvic pain and muscle dysfunction, while pelvic organ prolapse may result in muscle weakening due to the displacement of pelvic organs. Fistulas can also contribute to muscle wasting due to chronic inflammation and tissue damage. Ovarian disorders, such as cysts or tumors, may cause pain and limit physical activity, further exacerbating muscle atrophy. Polyps in the female genital tract can lead to abnormal bleeding and discomfort, which may discourage exercise and contribute to muscle wasting. The diagnosis of pelvic muscle wasting often requires a thorough clinical evaluation, including a pelvic examination and imaging studies, to assess the underlying causes and extent of muscle atrophy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying conditions that can lead to pelvic muscle wasting
  • Need for comprehensive documentation to support the diagnosis
  • Potential overlap with other pelvic floor disorders
  • Variability in clinical presentation among patients

Audit Risk Factors

  • Inadequate documentation of the underlying causes of muscle wasting
  • Failure to link the diagnosis to specific clinical findings
  • Misclassification of muscle wasting as a primary diagnosis without supporting evidence
  • Inconsistent coding of associated conditions

Specialty Focus

Medical Specialties

Gynecology

Documentation Requirements

Detailed clinical notes on pelvic examinations, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with pelvic pain, urinary incontinence, or prolapse symptoms.

Billing Considerations

Ensure that all associated conditions are documented to support the diagnosis of pelvic muscle wasting.

Urology

Documentation Requirements

Comprehensive assessment of urinary function and pelvic floor integrity.

Common Clinical Scenarios

Patients with urinary incontinence or pelvic pain related to pelvic muscle dysfunction.

Billing Considerations

Collaboration with gynecologists may be necessary for comprehensive care.

Coding Guidelines

Inclusion Criteria

Use N81.84 When
  • According to ICD
  • 10 coding guidelines, N81
  • 84 should be used when pelvic muscle wasting is documented as a diagnosis
  • Coders must ensure that the condition is clearly linked to clinical findings and that any associated conditions are also coded appropriately

Exclusion Criteria

Do NOT use N81.84 When
  • Exclusion criteria include conditions that do not directly relate to muscle wasting

Related ICD-10 Codes

Related CPT Codes

58661CPT Code

Laparoscopic excision of ovarian cyst

Clinical Scenario

Used when a patient with ovarian disorders presents with pelvic muscle wasting.

Documentation Requirements

Document the indication for surgery and any findings related to muscle wasting.

Specialty Considerations

Gynecologists should ensure that the surgical report includes details on muscle condition.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of pelvic muscle wasting, enabling better tracking of this condition and its associated disorders. This specificity aids in research and treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of pelvic muscle wasting, enabling better tracking of this condition and its associated disorders. This specificity aids in research and treatment planning.

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 is pelvic muscle wasting?

Pelvic muscle wasting refers to the atrophy or weakening of the pelvic floor muscles, which can lead to functional impairments such as urinary incontinence and pelvic pain.

How is pelvic muscle wasting diagnosed?

Diagnosis typically involves a thorough clinical evaluation, including a pelvic examination and imaging studies to assess the extent of muscle atrophy.

What conditions are associated with pelvic muscle wasting?

Conditions such as endometriosis, pelvic organ prolapse, fistulas, ovarian disorders, and polyps of the female genital tract can contribute to pelvic muscle wasting.