Is N85.A a billable ICD-10-CM code?

Yes. N85.A is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does N85.A sit in the tabular list?

Diseases of the genitourinary system (N00-N99), in the block Noninflammatory disorders of female genital tract (N80-N98).

What cannot be coded together with N85.A?

N85.A carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

N85.A

N85.A — Isthmocele

Billable / specific codeICD-10-CM

N85.A is a billable, specific ICD-10-CM code for isthmocele. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

maternal care for cesarean scar defect (isthmocele) (O34.22)

Code also

Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.

any associated conditions such as:
abnormal uterine and vaginal bleeding, unspecified (N93.9)
female infertility of uterine origin (N97.2)
pelvic and perineal pain (R10.2-)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Isthmocele (non-pregnant state)

Risk adjustment

N85.A does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

How N85.A is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to N85.A.

Cesarean delivery, previous, affecting management of pregnancy›isthmocele(non-pregnant state)
Cesarean delivery, previous, affecting management of pregnancy›scar›defect(non-pregnant state)

Related codes at this level

Codes that share N85. If N85.A is not quite right, the correct code is usually one of these.

Questions about N85.A

Is N85.A a billable ICD-10-CM code?: Yes. N85.A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does N85.A sit in the tabular list?: Diseases of the genitourinary system (N00-N99), in the block Noninflammatory disorders of female genital tract (N80-N98).
What cannot be coded together with N85.A?: N85.A carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.