ICD-10 Coding for Pelvic Organ Prolapse(N81.3, N81.9)
Complete ICD-10-CM coding and documentation guide for Pelvic Organ Prolapse. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pelvic Organ Prolapse
N81.0-N81.9Primary Range
Female genital prolapse
This range includes all types of pelvic organ prolapse, such as cystocele, rectocele, and uterovaginal prolapse.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N81.3 | Complete uterovaginal prolapse | Use when there is complete prolapse involving multiple compartments. |
|
| N81.9 | Female genital prolapse, unspecified | Use only when provider documentation lacks specificity. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for complete uterovaginal prolapse
Essential facts and insights about Pelvic Organ Prolapse
Primary ICD-10-CM Codes for pelvic organ prolapse
Decision Criteria
clinical Criteria
- Complete uterovaginal prolapse with stage III or IV
N81.9 - Female genital prolapse, unspecified
Use only when provider documentation lacks specificity.
Clinical Validation Requirements
- Lack of specific documentation for type of prolapse
Coding Notes
Query provider for more specific documentation if possible.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Pelvic Organ Prolapse to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N81.3.
Impact
Clinical: Loss of detailed clinical data., Regulatory: Potential audit flags., Financial: Reduced reimbursement rates.
Mitigation Strategy
Ensure complete documentation review, Query provider for specifics
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use only N81.3 as it includes cystocele and rectocele.
Impact
High risk of audit if unspecified codes are used without justification.
Mitigation Strategy
Ensure specific documentation and query providers as needed.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Pelvic Organ Prolapse, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pelvic Organ Prolapse
Use these documentation templates to ensure complete and accurate documentation for Pelvic Organ Prolapse. These templates include all required elements for proper coding and billing.
Complete uterovaginal prolapse with surgical repair
Specialty: GynecologyRequired Elements
- POP-Q measurements
- Stage of prolapse
- Symptoms and physical exam findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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