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

ICD-10 O70.1

Billable / Specific

Second degree perineal laceration during delivery

O70
Block
3
Synonyms
0
LCDs
0
Payer Policies
0
Linked CPTs

About ICD-10-CM O70.1

ICD-10-CM code O70.1 represents Second degree perineal laceration during delivery. This is a billable/specific code in the Pregnancy, Childbirth, and Puerperium chapter (block O70). The 2026 edition of ICD-10-CM O70.1 became effective on October 1, 2025.

Coding Tips for O70.1

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Pregnancy chapter (O00-O9A): trimester required

Most O codes require a 7th character indicating trimester (1 = first, 2 = second, 3 = third). Some require fetus identification character. Code O09 (supervision of high-risk pregnancy) is required as a secondary code when applicable.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under O70.1. Per CMS ICD-10-CM Tabular 2026.

  • Perineal laceration, rupture or tear during delivery as in O70.0, also involving pelvic floor
  • Perineal laceration, rupture or tear during delivery as in O70.0, also involving perineal muscles
  • Perineal laceration, rupture or tear during delivery as in O70.0, also involving vaginal muscles

Type 1 Excludes

Pure excludes, these codes can never be coded together with O70.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • perineal laceration involving anal sphincter (O70.2-)

Medicare LCD Coverage for O70.1

Local Coverage Determinations (LCDs) from CMS MACs that list O70.1 as a covered diagnosis.

No Medicare LCDs reference O70.1 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 O70.1.

No commercial payer policies reference O70.1 on file

Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but O70.1 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.

CPT Codes Commonly Billed with O70.1

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

No procedure linkages on file for O70.1

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 O70.1 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
O70.1 66411 10000
O70.1 66414 10000

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

ICD-10 O70.1, Billing FAQ

Is ICD-10 code O70.1 billable? +

Yes, O70.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to O70.1? +

ICD-10 O70.1 includes: Perineal laceration, rupture or tear during delivery as in O70.0, also involving pelvic floor; Perineal laceration, rupture or tear during delivery as in O70.0, also involving perineal muscles; Perineal laceration, rupture or tear during delivery as in O70.0, also involving vaginal muscles.

What codes are Type 1 Excludes for O70.1? +

Type 1 Excludes (never code together with O70.1): perineal laceration involving anal sphincter (O70.2-)

What ICD-9 codes does O70.1 map to? +

Per CMS GEMs, O70.1 maps to ICD-9 codes: 66411, 66414. 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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