O70 vs O70.4
O70 and O70.4 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 O70.4
anal sphincter tear with third degree perineal laceration (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
O70.4
Anal sphincter tear complicating delivery, not associated with third degree laceration
Billable
- Chapter 15
- Pregnancy, childbirth and the puerperium
- Section
- O60-O77
Indexed under
- Tear, torn › anus, anal › complicating delivery › without third degree perineal laceration (traumatic)
- Delivery › complicated › by › laceration › anus (childbirth) (labor)
- Delivery › complicated › by › laceration › anus › without third degree laceration (childbirth) (labor)
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