N85.4 vs O65.5
N85.4 and O65.5 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.
Malposition of uterus
- Chapter 14
- Diseases of the genitourinary system
- Section
- N80-N98
- Anteversion of uterus
- Retroflexion of uterus
- Retroversion of uterus
- Anteversion › uterus, uterine (cervix) (postinfectional) (postpartal, old)
- Lateroversion › uterus, uterine (cervix) (postinfectional) (postpartal, old)
- Malposition › uterus (acute) (acquired) (adherent) (asymptomatic) (postinfectional) (postpartal, old)
- Retroversion, retroverted › uterus (acquired) (acute) (any degree) (asymptomatic) (cervix) (postinfectional) (postpartal, old)
- Malposition › uterus › anteflexion or anteversion
Obstructed labor due to abnormality of maternal pelvic organs
- Chapter 15
- Pregnancy, childbirth and the puerperium
- Section
- O60-O77
- Obstructed labor due to conditions listed in O34.-
- Bicornate or bicornis uterus › in pregnancy or childbirth › causing obstructed labor
- Cystocele › in pregnancy or childbirth › causing obstructed labor
- Fibroid › in pregnancy or childbirth › causing obstructed labor
- 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