N81.4 vs N81.6
N81.4 and N81.6 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 N81.6
rectocele 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 (acquired) (recurrent)
- Prolapse, prolapsed › uterovaginal
- Prolapse, prolapsed › uterus
N81.6
Rectocele
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N80-N98
Use when the record says
- Prolapse of posterior vaginal wall
Indexed under
- Hernia, hernial › rectovaginal (acquired) (recurrent)
- Proctocele › female
- Rectocele › female
- Prolapse, prolapsed › vagina › posterior wall
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