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O71.4 vs S31.43XA

O71.4 (Obstetric high vaginal laceration alone) compared with S31.43XA (Puncture wound without foreign body of vagina and vulva, initial encounter), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

No — do not report together. S31.43XA carries an Excludes1 note covering O71.4: “injury to vagina and vulva during delivery (O70.-, O71.4)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

O71.4Obstetric high vaginal laceration aloneS31.43XAPuncture wound without foreign body of vagina and vulva, initial encounter
Billing statusBillableBillable
ClassificationO00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A)S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
DefinitionObstetric high vaginal laceration alone is a billable ICD-10-CM diagnosis code (O71.4).Puncture wound without foreign body of vagina and vulva, initial encounter is a billable ICD-10-CM diagnosis code (S31.43A).
7th characterThe appropriate 7th character is to be added to each code from category S31
Includes
obstetric damage from instruments
Laceration of vaginal wall without perineal laceration
injuries to the abdominal wall
injuries to the anus
injuries to the buttock
injuries to the external genitalia

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources