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v1.0.0
ICD-10 Guide
ICD-10 CodesN82.0

N82.0

Billable

Vesicovaginal fistula

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

Code Description

ICD-10 N82.0 is a billable code used to indicate a diagnosis of vesicovaginal fistula.

Key Diagnostic Point:

A vesicovaginal fistula is an abnormal connection between the bladder and the vagina, leading to involuntary leakage of urine into the vaginal canal. This condition can arise from various causes, including obstetric trauma, surgical complications, malignancies, or chronic inflammatory conditions such as endometriosis. Women with vesicovaginal fistulas often experience significant physical and psychological distress, as the condition can lead to social isolation and decreased quality of life. Diagnosis typically involves a thorough clinical examination, imaging studies, and sometimes cystoscopy to visualize the fistula. Treatment usually requires surgical intervention to repair the fistula, and the success of the procedure can depend on the underlying cause and the patient's overall health. In cases where the fistula is associated with pelvic organ prolapse or endometriosis, comprehensive management of these conditions is essential for optimal outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes (e.g., obstetric, surgical, inflammatory)
  • Potential for coexisting conditions (e.g., endometriosis, prolapse)
  • Need for detailed documentation of surgical history and complications
  • Variability in treatment approaches and outcomes

Audit Risk Factors

  • Inadequate documentation of the fistula's etiology
  • Failure to document associated conditions (e.g., endometriosis, prolapse)
  • Incorrect coding of surgical procedures related to fistula repair
  • Lack of follow-up documentation post-surgery

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed surgical history, imaging results, and treatment plans.

Common Clinical Scenarios

Management of urinary incontinence due to vesicovaginal fistula, post-surgical complications.

Billing Considerations

Urologists must document the type of fistula and any associated pelvic conditions for accurate coding.

Gynecology

Documentation Requirements

Comprehensive pelvic examination findings, history of obstetric events, and any prior surgeries.

Common Clinical Scenarios

Repair of vesicovaginal fistula following childbirth or pelvic surgery.

Billing Considerations

Gynecologists should ensure that all relevant comorbidities, such as endometriosis and prolapse, are documented.

Coding Guidelines

Inclusion Criteria

Use N82.0 When
  • According to ICD
  • 10 guidelines, N82
  • 0 should be used when there is a confirmed diagnosis of vesicovaginal fistula
  • Coders must ensure that the documentation supports the diagnosis and any associated conditions

Exclusion Criteria

Do NOT use N82.0 When
  • Exclusion criteria include conditions that do not involve a fistula or are related to other types of urinary incontinence

Related ICD-10 Codes

Related CPT Codes

57260CPT Code

Repair of vesicovaginal fistula

Clinical Scenario

Used when a patient undergoes surgical repair of a diagnosed vesicovaginal fistula.

Documentation Requirements

Operative report detailing the procedure, findings, and any complications.

Specialty Considerations

Urologists and gynecologists must ensure accurate coding based on the surgical approach used.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of vesicovaginal fistulas, improving the accuracy of data collection and reimbursement processes. The granularity of ICD-10 codes helps in better understanding the epidemiology and treatment outcomes of this condition.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of vesicovaginal fistulas, improving the accuracy of data collection and reimbursement processes. The granularity of ICD-10 codes helps in better understanding the epidemiology and treatment outcomes of this condition.

Reimbursement & Billing Impact

reimbursement processes. The granularity of ICD-10 codes helps in better understanding the epidemiology and treatment outcomes of this condition.

Resources

Clinical References

  • •
    American Urological Association Guidelines
  • •
    American College of Obstetricians and Gynecologists Practice Bulletins

Coding & Billing References

  • •
    American Urological Association Guidelines
  • •
    American College of Obstetricians and Gynecologists Practice Bulletins

Frequently Asked Questions

What are the common causes of vesicovaginal fistula?

Common causes include obstetric trauma, surgical complications, malignancies, and chronic inflammatory conditions such as endometriosis.

How is vesicovaginal fistula diagnosed?

Diagnosis typically involves a clinical examination, imaging studies, and sometimes cystoscopy to visualize the fistula.

What is the treatment for vesicovaginal fistula?

Treatment usually requires surgical repair of the fistula, with success rates varying based on the underlying cause and patient health.