N36.0 vs N82.1
N36.0 and N82.1 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 N36.0
urethrovaginal fistula (N82.1)
N36.0
Urethral fistula
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N30-N39
Use when the record says
- Urethroperineal fistula
- Urethrorectal fistula
- Urinary fistula NOS
Indexed under
- Fistula › perineum, perinealNEC (cutaneous)
- Fistula › rectourethral (cutaneous)
- Fistula › urethra (cutaneous)
- Fistula › urethroperineal (cutaneous)
- Fistula › urethrorectal (cutaneous)
N82.1
Other female urinary-genital tract fistulae
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N80-N98
Use when the record says
- Cervicovesical fistula
- Ureterovaginal fistula
- Urethrovaginal fistula
- Uteroureteric fistula
- Uterovesical fistula
Indexed under
- Fistula › cervicovesical (cutaneous)
- Fistula › ureterovaginal (cutaneous)
- Fistula › urethrovaginal (cutaneous)
- Fistula › uteroureteric (cutaneous)
- Fistula › uterovesical (cutaneous)
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