N81.6: Rectocele
N81.6 is a billable, specific ICD-10-CM code for rectocele. It is valid for submission on a claim.
Check N81.6 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Excludes2: not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Use additional code
Add a secondary code to capture the detail described below.
- code for any associated fecal incontinence, if applicable (R15.-)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Prolapse of posterior vaginal wall
Excludes1 inherited from the categories above N81.6
A category’s note binds every code beneath it.
Other codes that can never be billed with N81.6
Their own Excludes1 notes name this code, so the conflict is not listed above.
- N85Other noninflammatory disorders of uterus, except cervix
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
N81.6 is named in 3 Medicare coverage policies: 3 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56802Billing and Coding: Urodynamics
- A57455Billing and Coding: Urodynamics
Alphabetic index entries that lead here
- Hernia, hernial›rectovaginal
- Proctocele›female(without uterine prolapse)
- Rectocele›female(without uterine prolapse)
- Prolapse, prolapsed›vagina›posterior wall
Code history
Unchanged in every release from FY2024 to FY2027.