AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2016 Issue 1

Obstetric Perineal Laceration Repair

Obstetric perineal lacerations occur within the supportive layer of tissue between the vaginal introitus and the rectum commonly called the perineum. The perineal body marks the point where the perineal muscles converge. The outermost layer (skin) of the perineum, may only be involved or the tear can extend into the muscles of the perineal body. It can also continue into the anal sphincter and the mucosal layers of the anus and rectum. For coding, obstetric perineal lacerations or tears are classified as follows: First degree—Involving the perineal skin and its extension into the vagina as vaginal mucosa Second...

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