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ICD-10 Guide
ICD-10 CodesN94.819

N94.819

Billable

Vulvodynia, unspecified

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

Code Description

ICD-10 N94.819 is a billable code used to indicate a diagnosis of vulvodynia, unspecified.

Key Diagnostic Point:

Vulvodynia is a chronic pain condition affecting the vulvar area, characterized by discomfort, burning, or pain that persists for at least three months without an identifiable cause. This condition can significantly impact a woman's quality of life, affecting sexual function, emotional well-being, and daily activities. Vulvodynia can be classified into generalized vulvodynia, which affects the entire vulvar area, and localized vulvodynia, which is confined to specific areas. The etiology of vulvodynia is multifactorial, potentially involving neuropathic, inflammatory, hormonal, and psychological components. It is often associated with other conditions such as menstrual disorders, menopausal disorders, and female infertility, as hormonal fluctuations can exacerbate symptoms. Diagnosis typically involves a thorough clinical evaluation, including a detailed history and physical examination, to rule out other causes of vulvar pain. Treatment options may include topical anesthetics, pelvic floor physical therapy, and counseling, but the effectiveness can vary widely among individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in symptom presentation among patients
  • Need for comprehensive differential diagnosis
  • Potential overlap with other gynecological conditions
  • Lack of standardized treatment protocols

Audit Risk Factors

  • Inadequate documentation of symptom duration
  • Failure to rule out other conditions
  • Lack of detailed treatment plans
  • Insufficient patient history regarding menstrual and reproductive health

Specialty Focus

Medical Specialties

Gynecology

Documentation Requirements

Detailed patient history, including menstrual and reproductive health, and thorough physical examination findings.

Common Clinical Scenarios

Patients presenting with chronic vulvar pain, discomfort during intercourse, or pain exacerbated by hormonal changes.

Billing Considerations

Consideration of comorbid conditions such as endometriosis or pelvic inflammatory disease that may contribute to symptoms.

Pain Management

Documentation Requirements

Comprehensive pain assessment, including pain scales and impact on daily activities.

Common Clinical Scenarios

Patients seeking multidisciplinary approaches to manage chronic vulvar pain.

Billing Considerations

Coordination with gynecologists for holistic treatment plans.

Coding Guidelines

Inclusion Criteria

Use N94.819 When
  • According to ICD
  • 10 guidelines, N94
  • 819 should be used when vulvodynia is diagnosed but not specified as generalized or localized
  • Coders must ensure that the diagnosis is supported by clinical documentation and that other potential causes of vulvar pain have been ruled out

Exclusion Criteria

Do NOT use N94.819 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits for vulvodynia management.

Documentation Requirements

Document patient history, symptom severity, and treatment response.

Specialty Considerations

Gynecologists should ensure comprehensive documentation to support the visit level.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more precise coding of vulvodynia, enabling better tracking of the condition's prevalence and treatment outcomes. This specificity aids in research and improves patient care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more precise coding of vulvodynia, enabling better tracking of the condition's prevalence and treatment outcomes. This specificity aids in research and improves patient care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more precise coding of vulvodynia, enabling better tracking of the condition's prevalence and treatment outcomes. This specificity aids in research and improves patient care.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What is vulvodynia?

Vulvodynia is a chronic pain condition affecting the vulvar area, characterized by discomfort or pain that persists for at least three months without an identifiable cause.

How is vulvodynia diagnosed?

Diagnosis involves a thorough clinical evaluation, including a detailed history and physical examination, to rule out other causes of vulvar pain.

What are the treatment options for vulvodynia?

Treatment may include topical anesthetics, pelvic floor physical therapy, counseling, and other multidisciplinary approaches tailored to the individual patient's needs.