ICD-10 Coding for Labial Abscess(N76.4, N75.1)
Complete ICD-10-CM coding and documentation guide for Labial Abscess. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Labial Abscess
N70-N77Primary Range
Inflammatory diseases of female pelvic organs
This range includes codes for inflammatory conditions of the vulva, including labial abscess.
Bacterial and viral infectious agents
These codes are used to identify infectious agents responsible for diseases classified elsewhere, such as labial abscess.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N76.4 | Abscess of vulva | Use for abscesses located on the labia majora or minora not involving the Bartholin's gland. |
|
| N75.1 | Abscess of Bartholin's gland | Use when the abscess involves the Bartholin's gland. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for labial abscess
Essential facts and insights about Labial Abscess
Primary ICD-10-CM Codes for labial abscess
Decision Criteria
clinical Criteria
- Presence of a fluctuant, erythematous mass on the labia with purulent drainage.
coding Criteria
- Abscess not involving the Bartholin's gland.
documentation Criteria
- Specify laterality and exact location on the labia.
Applicable To
- Labial abscess not involving Bartholin's gland
Excludes
- Abscess of Bartholin's gland (N75.1)
Clinical Validation Requirements
- Presence of erythema, swelling, and purulent drainage
- Culture results identifying causative organism
Code-Specific Risks
- Confusion with N75.1 if the abscess involves the Bartholin's gland
Coding Notes
- Ensure documentation specifies the location and whether the Bartholin's gland is involved to avoid coding errors.
N75.1 - Abscess of Bartholin's gland
Use when the abscess involves the Bartholin's gland.
Applicable To
- Bartholin's gland abscess
Excludes
- Abscess of vulva not involving Bartholin's gland (N76.4)
Clinical Validation Requirements
- Abscess located at the posterolateral aspect of the vaginal introitus
- Swelling and tenderness in the area of the Bartholin's gland
Coding Notes
Ensure documentation specifies involvement of the Bartholin's gland to avoid coding errors.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Labial Abscess to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N76.4.
Impact
Clinical: May lead to incorrect treatment decisions., Regulatory: Could result in coding errors and audits., Financial: Potential for denied claims or incorrect reimbursement.
Mitigation Strategy
Always document the side (left/right) and specific location., Use templates to ensure all elements are captured.
Impact
Reimbursement: Incorrect coding could lead to underpayment or overpayment., Compliance: Misclassification may result in audit issues., Data Quality: Inaccurate data collection affecting clinical outcomes.
Mitigation Strategy
Verify the location of the abscess to determine if the Bartholin's gland is involved.
Impact
Using N76.4 instead of N75.1 for Bartholin's gland abscess.
Mitigation Strategy
Ensure thorough documentation of the abscess location and gland involvement.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Labial Abscess, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Labial Abscess
Use these documentation templates to ensure complete and accurate documentation for Labial Abscess. These templates include all required elements for proper coding and billing.
Emergency Department Visit for Labial Abscess
Specialty: Emergency MedicineRequired Elements
- Location and size of the abscess
- Presence of erythema and purulence
- Procedure details (I&D, packing)
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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