Excludes1 pair
O70- vs O70.1
O70 and O70.1 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 O70.1
perineal laceration involving anal sphincter (O70.2-)
O70
Perineal laceration during delivery
Not billable
- Chapter 15
- Pregnancy, childbirth and the puerperium
- Section
- O60-O77
Use when the record says
- episiotomy extended by laceration
O70.1
Second degree perineal laceration during delivery
Billable
- Chapter 15
- Pregnancy, childbirth and the puerperium
- Section
- O60-O77
Use when the record says
- Perineal laceration, rupture or tear during delivery as in O70.0, also involving pelvic floor
- Perineal laceration, rupture or tear during delivery as in O70.0, also involving perineal muscles
- Perineal laceration, rupture or tear during delivery as in O70.0, also involving vaginal muscles
Indexed under
- Injury › pelvis, pelvic › complicating delivery
- Rupture, ruptured › pelvic › floor, complicating delivery
- Tear, torn › pelvic › floor, complicating delivery
- Laceration › pelvic › floor › complicating delivery
- Perforation, perforated › pelvic › floor › obstetrical trauma
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