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ICD-10 Guide
ICD-10 CodesN82.9

N82.9

Billable

Female genital tract fistula, unspecified

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

Code Description

ICD-10 N82.9 is a billable code used to indicate a diagnosis of female genital tract fistula, unspecified.

Key Diagnostic Point:

Female genital tract fistula refers to an abnormal connection between the female genital tract and another organ or structure, which can lead to significant clinical complications. This condition may arise from various etiologies, including obstetric trauma, surgical complications, or chronic inflammatory conditions such as endometriosis. Endometriosis can lead to the formation of adhesions and subsequent fistulas, particularly when the disease affects the bowel or bladder. Female genital prolapse, characterized by the descent of pelvic organs, can also contribute to the development of fistulas, especially in cases where the structural integrity of the pelvic floor is compromised. Ovarian disorders, such as cysts or tumors, may indirectly lead to fistula formation through inflammatory processes or surgical interventions. Additionally, polyps in the female genital tract can create localized areas of irritation or obstruction, potentially resulting in fistula formation. The unspecified nature of this code indicates that the specific type of fistula is not documented, which may complicate treatment and management strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and underlying causes
  • Need for detailed documentation to specify type and location of fistula
  • Potential overlap with other gynecological conditions
  • Variations in treatment protocols based on etiology

Audit Risk Factors

  • Insufficient documentation of the fistula's characteristics
  • Failure to specify associated conditions such as endometriosis or prolapse
  • Inconsistent coding practices among providers
  • Lack of clarity in the clinical narrative regarding the fistula's origin

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed clinical notes describing the fistula's location, type, and associated conditions are essential.

Common Clinical Scenarios

Management of patients with obstetric fistulas, endometriosis-related complications, or pelvic organ prolapse.

Billing Considerations

Accurate documentation of surgical history and any prior interventions is crucial for proper coding.

Urology

Documentation Requirements

Urological assessments and imaging studies should be documented to support the diagnosis.

Common Clinical Scenarios

Evaluation and management of urinary fistulas secondary to pelvic surgery or malignancy.

Billing Considerations

Collaboration with gynecologists may be necessary for comprehensive care.

Coding Guidelines

Inclusion Criteria

Use N82.9 When
  • According to ICD
  • 10 coding guidelines, N82
  • 9 should be used when the specific type of female genital tract fistula is not documented
  • Coders should ensure that all relevant clinical information is captured to support the diagnosis
  • It is important to review the patient's history and any imaging studies to determine if a more specific code can be applied

Exclusion Criteria

Do NOT use N82.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

58150CPT Code

Total abdominal hysterectomy

Clinical Scenario

Often performed in cases of severe endometriosis or prolapse leading to fistula formation.

Documentation Requirements

Operative reports must detail the procedure and any findings related to fistula.

Specialty Considerations

Obstetricians and gynecologists should ensure comprehensive documentation of the surgical approach.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more detailed coding of conditions like female genital tract fistulas, enabling better tracking of treatment outcomes and healthcare utilization. However, the unspecified nature of N82.9 may lead to challenges in accurately capturing the complexity of patient cases.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding of conditions like female genital tract fistulas, enabling better tracking of treatment outcomes and healthcare utilization. However, the unspecified nature of N82.9 may lead to challenges in accurately capturing the complexity of patient cases.

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 the significance of using N82.9?

N82.9 is used when the specific type of female genital tract fistula is not documented. It is important to ensure that all relevant clinical information is captured to support the diagnosis and treatment.