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2025 ICD-10-CM code A18.18

Tuberculosis of other female genital organs.This includes tuberculous ulceration of the vulva and vagina.

Use additional code Z16.- to identify any resistance to antimicrobial drugs.Do not use this code for carrier status (Z22.-), infections complicating pregnancy, childbirth, or the puerperium (O98.-), or infections specific to the perinatal period (P35-P39).

Medical necessity for treatment is established by confirming the diagnosis of tuberculosis in the affected genital organ(s). This usually involves a positive culture or histopathological findings consistent with TB on a biopsy sample.

Diagnosis of TB of the vulva, vagina, and other female genital structures is often challenging due to its rarity. It's frequently linked to infections in the upper genital tract but can also be transmitted sexually. Symptoms may include swelling and skin changes from blocked lymph flow (lymphedema), a cheesy, pus-filled, wart-like growth on the genitals, abnormal bleeding, persistent foul-smelling discharge, abdominal swelling, pelvic pain, and absence of menstruation (amenorrhea) or infertility. Diagnosis involves physical examination, blood tests, tuberculin skin test, medical history, and possibly imaging studies or a biopsy.

In simple words: Tuberculosis can sometimes affect the outer parts of a woman's genitals like the vulva and vagina. This is uncommon and happens when the bacteria that cause TB travel from another infected part of the body to the genitals. It can cause sores and swelling.

Tuberculosis (TB) of other female genital organs is a rare form of extrapulmonary tuberculosis affecting female reproductive organs other than the ovaries, fallopian tubes, uterus, and cervix.It occurs when Mycobacterium tuberculosis bacilli spread through the blood or lymph from an initial infection site, lodging in the genital area and forming granulomas. These granulomas may remain dormant for extended periods before rupturing and infecting the organ. This code specifically refers to TB of the vulva or vagina.

Example 1: A 30-year-old woman with a history of pulmonary tuberculosis presents with a painful, non-healing ulcer on her vulva. Biopsy confirms the presence of Mycobacterium tuberculosis., A 60-year-old woman with no prior history of tuberculosis develops a persistent, foul-smelling vaginal discharge and swelling. A pelvic exam reveals a lesion, and a biopsy confirms genital tuberculosis., A woman with HIV and a history of treated abdominal tuberculosis presents with pelvic pain and irregular bleeding.Imaging and laparoscopy identify granulomas on the vulva and vagina, consistent with tuberculosis.

Documentation should include details of the patient's history, physical examination findings (including the appearance and location of lesions), results of diagnostic tests (e.g., biopsy, AFB smear, culture, imaging), and any associated symptoms.A history of tuberculosis or related risk factors should also be noted.

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