I86.3 vs O22
I86.3 and O22 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on I86.3
vulval varices complicating pregnancy (O22.1-)
I86.3
Vulval varices
Billable
- Chapter 9
- Diseases of the circulatory system
- Section
- I80-I89
Indexed under
- Varicocele › perineum (scrotum) (thrombosed)
- Varix › labia (lower limb)
- Varix › perineum (lower limb)
- Varix › vulva (lower limb)
- Ulcer, ulcerated, ulcerating, ulceration, ulcerative › varicose › perineum
O22
Venous complications and hemorrhoids in pregnancy
Not billable
- Chapter 15
- Pregnancy, childbirth and the puerperium
- Section
- O20-O29
These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027