FY2027
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Excludes1 pair

O70- vs O71.4

O70 and O71.4 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 O70
obstetric high vaginal laceration alone (O71.4)
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
O71.4

Obstetric high vaginal laceration alone

Billable
Chapter 15
Pregnancy, childbirth and the puerperium
Section
O60-O77
Use when the record says
  • Laceration of vaginal wall without perineal laceration
Indexed under
  • Laceration › vagina › during delivery
  • Perforation, perforated › vagina › obstetrical trauma
  • Injury › instrumental › obstetrical › high vaginal
  • Delivery › complicated › by › laceration › rectovaginal (septum) (without perineal laceration)
  • Delivery › complicated › by › laceration › vagina, vaginal (deep) (high) (without perineal laceration)

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