ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 N81.5

Billable / Specific

Vaginal enterocele

N81
Block
0
Synonyms
0
LCDs
0
Payer Policies
0
Linked CPTs

About ICD-10-CM N81.5

ICD-10-CM code N81.5 represents Vaginal enterocele. This is a billable/specific code in the Genitourinary System chapter (block N81). The 2026 edition of ICD-10-CM N81.5 became effective on October 1, 2025.

Type 1 Excludes

Pure excludes, these codes can never be coded together with N81.5. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • enterocele with prolapse of uterus (N81.2-N81.4)

Medicare LCD Coverage for N81.5

Local Coverage Determinations (LCDs) from CMS MACs that list N81.5 as a covered diagnosis.

No Medicare LCDs reference N81.5 as covered

This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.

Commercial Payer Coverage

Coverage policies from major commercial payers referencing N81.5.

No commercial payer policies reference N81.5 on file

Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but N81.5 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.

CPT Codes Commonly Billed with N81.5

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for N81.5

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert N81.5 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
N81.5 6186 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 N81.5, Billing FAQ

Is ICD-10 code N81.5 billable? +

Yes, N81.5 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 1 Excludes for N81.5? +

Type 1 Excludes (never code together with N81.5): enterocele with prolapse of uterus (N81.2-N81.4)

What ICD-9 codes does N81.5 map to? +

Per CMS GEMs, N81.5 maps to ICD-9 codes: 6186. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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