Ob-Gyn Coding Alert

Don't overlook these Excludes1 notes.

If a patient has leukorrhea, she has whitish, yellowish, or greenish discharge from the vagina. The discharge can be normal or the sign of an infection.

Right now, you should report this condition with 623.5 (Leukorrhea not specified as infective). When you switch to ICD-10 in October 2013, you should report N98.8 (Other specified noninflammatory disorders of vagina) instead. These two codes have a one-to-one correlation, but you should examine how the descriptors differ.

Documentation: You should turn to code N89.8 when the provider documents leukorrhea. If your provider documents leukorrhea NOS, you'll still turn to N89.8 because this term appears as an explanatory term under N89.8.

Here's how you will arrive at these codes from the Alphabetic Index (specific to vaginal discharge):

- vaginal N89.8

Leukorrhea N89.8

Coder tips: Underneath the N89- category, you will find an Excludes1 note that forbids you from reporting these codes with abnormal results from cervical cytologic examination without histologic confirmation (R87.61-), carcinoma in situ of cervix uteri (D06-), HGSIL of vagina (R87.623), inflammation of vagina (N76-), senile (atrophic) vaginitis (N95.2), severe dysplasia of vagina (D07.2), trichomonal leukorrhea (A95.00), and vaginal intraepithelial neoplasia [VAIN], grade III (D07.2).

Under N89.8 itself, you'll see another Excludes1 note that forbids you from reporting this code with current obstetric trauma (O70-, O71.4, O71.7, O71.8) and old laceration involving muscles of pelvic floor (N81.8).