FY2027
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Excludes1 pair

N81.4 vs N81.5

N81.4 and N81.5 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.

The official note, declared on N81.5
enterocele with prolapse of uterus (N81.2-N81.4)
N81.4

Uterovaginal prolapse, unspecified

BillableUnspecified
Chapter 14
Diseases of the genitourinary system
Section
N80-N98
Use when the record says
  • Prolapse of uterus NOS
Indexed under
  • Eversion › uterus
  • Extroversion › uterus
  • Hernia, hernial › uterus
  • Prolapse, prolapsed › uterovaginal
  • Prolapse, prolapsed › uterus (with prolapse of vagina)
N81.5

Vaginal enterocele

Billable
Chapter 14
Diseases of the genitourinary system
Section
N80-N98
Indexed under
  • Colpocele
  • Enterocele › pelvic, pelvis (acquired) (congenital)
  • Enterocele › vagina, vaginal NEC (acquired) (congenital)

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