FY2027
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Excludes1 pair

N89.5 vs Q52.4

N89.5 and Q52.4 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 N89.5
congenital atresia or stricture (Q52.4)
N89.5

Stricture and atresia of vagina

Billable
Chapter 14
Diseases of the genitourinary system
Section
N80-N98
Use when the record says
  • Vaginal adhesions
  • Vaginal stenosis
Indexed under
  • Adhesions, adhesive › vagina (chronic)
  • Band › vagina
  • Closure › vagina
  • Contraction, contracture, contracted › vagina (outlet)
  • Obstruction, obstructed, obstructive › vagina
Q52.4

Other congenital malformations of vagina

Billable
Chapter 17
Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
Section
Q50-Q56
Use when the record says
  • Canal of Nuck cyst, congenital
  • Congenital malformation of vagina NOS
  • Embryonic vaginal cyst
  • Gartner's duct cyst
Indexed under
  • Absence › hymen (congenital)
  • Accessory › hymen
  • Agenesis › hymen
  • Anomaly, anomalous › canal of Nuck
  • Anomaly, anomalous › Gartner's duct

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