O70.4 — Anal sphincter tear complicating delivery, not associated with third degree laceration
O70.4 is a billable, specific ICD-10-CM code for anal sphincter tear complicating delivery, not associated with third degree laceration. 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.
- anal sphincter tear with third degree perineal laceration (O70.2-)
Other codes that can never be billed with O70.4
These codes carry an Excludes1 note pointing at O70.4. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading O70.4 alone.
- O70.2Third degree perineal laceration during delivery
Risk adjustment
O70.4 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 O70.4 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 O70.4.
- Tear, torn›anus, anal›complicating delivery›without third degree perineal laceration
- Delivery›complicated›by›laceration›anus(sphincter)
- Delivery›complicated›by›laceration›anus›without third degree laceration
Related codes at this level
Codes that share O70. If O70.4 is not quite right, the correct code is usually one of these.
Questions about O70.4
- Is O70.4 a billable ICD-10-CM code?
- Yes. O70.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does O70.4 sit in the tabular list?
- Pregnancy, childbirth and the puerperium (O00-O9A), in the block Complications of labor and delivery (O60-O77).
- What cannot be coded together with O70.4?
- O70.4 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.