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 Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above N85.A (N85) and apply to it just the same.

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)

Excludes1 inherited from the categories above N85.A

These are not written on N85.A, but they bind it: a note on a category applies to every code beneath it. Billing N85.A with anything listed here is a denial.

Written on N85 — Other noninflammatory disorders of uterus, except cervix

endometriosis (N80.-)
inflammatory diseases of uterus (N71.-)
noninflammatory disorders of cervix, except malposition (N86-N88)
polyp of corpus uteri (N84.0)
uterine prolapse (N81.-)

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)

Code history

N85.A has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

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 Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above N85.A (N85) and apply to it just the same.