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v1.0.0
ICD-10 Guide
ICD-10 CodesN81.89

N81.89

Billable

Other female genital prolapse

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

Code Description

ICD-10 N81.89 is a billable code used to indicate a diagnosis of other female genital prolapse.

Key Diagnostic Point:

Other female genital prolapse refers to a condition where there is a descent of the pelvic organs, including the uterus, vagina, bladder, or rectum, through the vaginal canal due to weakened pelvic support structures. This condition can manifest in various forms, such as uterine prolapse, cystocele (bladder prolapse), or rectocele (rectal prolapse). It is often associated with childbirth, aging, obesity, and chronic conditions that increase intra-abdominal pressure. Symptoms may include pelvic pressure, urinary incontinence, difficulty with bowel movements, and a visible bulge in the vaginal area. The condition can significantly impact a woman's quality of life and may require surgical intervention or conservative management. In the context of endometriosis, pelvic organ prolapse can complicate the clinical picture, as both conditions may coexist and contribute to pelvic pain and dysfunction. Accurate diagnosis and coding are essential for appropriate treatment planning and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of prolapse
  • Overlap with other conditions such as endometriosis and pelvic floor disorders
  • Need for detailed documentation of symptoms and physical examination findings
  • Potential for multiple coexisting conditions requiring careful coding

Audit Risk Factors

  • Inadequate documentation of the type and severity of prolapse
  • Failure to document associated conditions like endometriosis or fistulas
  • Misclassification of prolapse type leading to incorrect coding
  • Lack of clarity in treatment plans and surgical interventions

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed pelvic examination findings, patient history, and treatment plans.

Common Clinical Scenarios

Management of pelvic organ prolapse, surgical interventions, and conservative treatment options.

Billing Considerations

Ensure accurate documentation of the type of prolapse and any associated conditions for proper coding.

Urology

Documentation Requirements

Comprehensive assessment of urinary symptoms and pelvic floor function.

Common Clinical Scenarios

Evaluation and management of urinary incontinence related to prolapse.

Billing Considerations

Document any urodynamic studies performed to support the diagnosis.

Coding Guidelines

Inclusion Criteria

Use N81.89 When
  • According to ICD
  • 10 coding guidelines, N81
  • 89 should be used when the specific type of female genital prolapse is not classified elsewhere
  • Coders should ensure that the documentation supports the diagnosis and that any associated conditions are also coded appropriately

Exclusion Criteria

Do NOT use N81.89 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

57260CPT Code

Vaginal repair of cystocele

Clinical Scenario

Used when a patient with N81.89 undergoes surgical repair of a cystocele.

Documentation Requirements

Operative report detailing the procedure and indication.

Specialty Considerations

Ensure that the diagnosis of prolapse is clearly linked to the surgical procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of female genital prolapse, improving the accuracy of diagnoses and treatment planning. N81.89 provides a broader category for cases that do not fit into more specific classifications, allowing for better tracking and management of these conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of female genital prolapse, improving the accuracy of diagnoses and treatment planning. N81.89 provides a broader category for cases that do not fit into more specific classifications, allowing for better tracking and management of these conditions.

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 are the common symptoms of female genital prolapse?

Common symptoms include pelvic pressure, urinary incontinence, difficulty with bowel movements, and a visible bulge in the vaginal area.

How is female genital prolapse diagnosed?

Diagnosis typically involves a pelvic examination, patient history, and may include imaging studies to assess the extent of the prolapse.