2025 ICD-10-CM code N81

Female genital prolapse

Code N81 should not be used with codes for genital prolapse complicating pregnancy, labor, or delivery (O34.5-), prolapse of the vaginal vault after hysterectomy (N99.3), or prolapse and hernia of the ovary and fallopian tube (N83.4-).Use the most specific code available for the type of prolapse (e.g., N81.1 for cystocele).

Medical necessity for treatment of female genital prolapse is established by the presence of bothersome symptoms impacting the patient's daily activities or quality of life.The severity of the prolapse and the chosen treatment option must be consistent with the patient's symptoms and overall health status.

Diagnosis and management of female genital prolapse typically falls under the purview of gynecologists, urogynecologists, or other specialists in pelvic floor disorders. They are responsible for evaluating the patient's condition, determining the severity of the prolapse, and recommending appropriate treatment options, which may range from conservative measures like pelvic floor exercises to surgical intervention.

In simple words: Female genital prolapse happens when the organs in a woman's pelvis, like the uterus, bladder, or rectum, drop down and push against the walls of the vagina. This can cause the vagina to bulge out.

Female genital prolapse is a condition where one or more of the pelvic organs (vagina, uterus, bladder, or rectum) bulge into the vagina or outside the vaginal opening.This occurs when the muscles and tissues supporting these organs weaken or are damaged.

Example 1: A 55-year-old woman presents with pelvic pressure and a sensation of a bulge in her vagina. Upon examination, she is diagnosed with a second-degree uterine prolapse., A 70-year-old woman with a history of multiple vaginal deliveries complains of urinary incontinence and difficulty emptying her bladder. She is found to have a cystocele (bladder prolapse)., A 40-year-old woman with a history of chronic constipation and straining experiences rectal prolapse, where part of her rectum protrudes from the anus.

Documentation should include details of the pelvic examination findings, including the degree of prolapse (if applicable), associated symptoms, and impact on the patient's quality of life. Any prior treatments and their effectiveness should also be noted. Imaging studies, such as ultrasound or MRI, may be necessary to confirm the diagnosis and assess the extent of the prolapse.

** Excludes1: genital prolapse complicating pregnancy, labor or delivery (O34.5-) prolapse and hernia of ovary and fallopian tube (N83.4-) prolapse of vaginal vault after hysterectomy (N99.3)

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.