N85.4 vs O65.5
N85.4 and O65.5 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.
N85.4
Malposition of uterus
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N80-N98
Use when the record says
- Anteversion of uterus
- Retroflexion of uterus
- Retroversion of uterus
Indexed under
- Anteversion › uterus, uterine
- Lateroversion › uterus, uterine
- Malposition › uterus
- Retroversion, retroverted › uterus
- Malposition › uterus › anteflexion or anteversion
O65.5
Obstructed labor due to abnormality of maternal pelvic organs
Billable
- Chapter 15
- Pregnancy, childbirth and the puerperium
- Section
- O60-O77
Use when the record says
- Obstructed labor due to conditions listed in O34.-
Indexed under
- Bicornate or bicornis uterus › in pregnancy or childbirth › causing obstructed labor
- Cystocele › in pregnancy or childbirth › causing obstructed labor (-urethrocele)
- Fibroid › in pregnancy or childbirth › causing obstructed labor (tumor)
- Fibrosis, fibrotic › perineum, in pregnancy or childbirth › causing obstructed labor
- Prolapse, prolapsed › cervix, cervical › anterior lip, obstructing labor
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