O71.4 vs S31.4
O71.4 and S31.4 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.
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 (nontraumatic) (of)
- Injury › instrumental › obstetrical › high vaginal
- Delivery › complicated › by › laceration › rectovaginal (childbirth) (labor)
- Delivery › complicated › by › laceration › vagina, vaginal (childbirth) (labor)
S31.4
Open wound of vagina and vulva
Not billable
- Chapter 19
- Injury, poisoning and certain other consequences of external causes
- Section
- S30-S39
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