K46 vs N81.5
K46 and N81.5 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 K46
vaginal enterocele (N81.5)
K46
Unspecified abdominal hernia
Not billable
- Chapter 11
- Diseases of the digestive system
- Section
- K40-K46
Use when the record says
- enterocele
- epiplocele
- hernia NOS
- interstitial hernia
- intestinal hernia
- intra-abdominal hernia
N81.5
Vaginal enterocele
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N80-N98
Indexed under
- Colpocele
- Enterocele › pelvic, pelvis
- Enterocele › vagina, vaginalNEC
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