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N90.4 ICD-10-CM Code: Leukoplakia of vulva

Compare with another codeCheck this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
3 inclusion terms · 7 Excludes1

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

Excludes1Never report with this code
  • anogenital (venereal) warts (A63.0)
  • carcinoma in situ of vulva (D07.1)
  • condyloma acuminatum (A63.0)
  • current obstetric trauma (O70.-, O71.7-O71.8)

+3 more in Instructions

IncludesWhat this code covers
  • Dystrophy of vulva
  • Kraurosis of vulva
  • Lichen sclerosus of external female genital organs

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 742 — UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC (MDC 13)
  • MS-DRG 743 — UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC (MDC 13)
  • MS-DRG 760 — MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC (MDC 13)
  • MS-DRG 761 — MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC (MDC 13)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for N90.4 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on N90.4 itself; “inherited from” names the category or block whose note applies here.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Dystrophy of vulva
  • Kraurosis of vulva
  • Lichen sclerosus of external female genital organs

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Coder workflow for N90.4

MedCoder structured workflow — derived from this code’s own official record

Before you code N90.4

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with N90.4. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in N90.4’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewA63.0, D07.1, O70, N76

Consider N90.4. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Severity
Mild, moderate or severe as the provider states it; severity is not inferred from the clinical picture.

Official instructions as workflow

  • Excludes1 — check before selecting N90.4(7 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with N90.4: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareA63.0, D07.1, O70, N76

    See the official tabular notes · Guidelines I.A.12.a

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition N90.4 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewA63.0, D07.1, O70, N76

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse N90.4 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of N90.4 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • A63.0— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of anogenital (venereal) warts moves the case to A63.0; the two are not reported together unless documented as unrelated.

    Full comparison: N90.4 vs A63.0 →

  • D07.1— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of carcinoma in situ of vulva moves the case to D07.1; the two are not reported together unless documented as unrelated.

    Full comparison: N90.4 vs D07.1 →

  • O70— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of current obstetric trauma moves the case to O70; the two are not reported together unless documented as unrelated.

    Full comparison: N90.4 vs O70 →

  • O71.7— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of current obstetric trauma moves the case to O71.7; the two are not reported together unless documented as unrelated.

    Full comparison: N90.4 vs O71.7 →

  • O71.8— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of current obstetric trauma moves the case to O71.8; the two are not reported together unless documented as unrelated.

    Full comparison: N90.4 vs O71.8 →

  • N76— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of inflammation of vulva moves the case to N76; the two are not reported together unless documented as unrelated.

    Full comparison: N90.4 vs N76 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Leukoplakia of vulva is a billable ICD-10-CM diagnosis code (N90.4).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name N90.4 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes2 note: L90.0 — Lichen sclerosus et atrophicus.

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 4 MS-DRGs: DRG 742 (MDC 13), DRG 743 (MDC 13), DRG 760 (MDC 13), DRG 761 (MDC 13).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):GEN025 — Other specified female genital disorders (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Other specified female genital disorders).

N89.1 — Moderate vaginal dysplasia, N89.3 — Dysplasia of vagina, unspecified, N89.4 — Leukoplakia of vagina, N89.5 — Stricture and atresia of vagina, N89.6 — Tight hymenal ring, N89.8 — Other specified noninflammatory disorders of vagina, N89.9 — Noninflammatory disorder of vagina, unspecified, N90.0 — Mild vulvar dysplasia, N90.1 — Moderate vulvar dysplasia, N90.3 — Dysplasia of vulva, unspecified, N90.5 — Atrophy of vulva, N90.6 — Hypertrophy of vulva, N90.60 — Unspecified hypertrophy of vulva, N90.61 — Childhood asymmetric labium majus enlargement, N90.69 — Other specified hypertrophy of vulva, N90.7 — Vulvar cyst, N90.810 — Female genital mutilation status, unspecified, N90.811 — Female genital mutilation Type I status, N90.812 — Female genital mutilation Type II status, N90.813 — Female genital mutilation Type III status, +94 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Vulvitis”, “Dystrophy, dystrophia”, “Hyperkeratosis”, …; these codes share that main term but sit in a different category of the Tabular List.

L98.5 — Mucinosis of the skin (myxedematosus), L98.8 — Other specified disorders of the skin and subcutaneous tissue (skin NEC), N28.89 — Other specified disorders of kidney and ureter (kidney), N32.89 — Other specified disorders of bladder (bladder), N36.8 — Other specified disorders of urethra (urethra), N48.0 — Leukoplakia of penis (penis), N76.2 — Acute vulvitis, N76.3 — Subacute and chronic vulvitis (subacute or chronic), N83.8 — Other noninflammatory disorders of ovary, fallopian tube and broad ligament (ovarian), N85.8 — Other specified noninflammatory disorders of uterus (uterus), N88.0 — Leukoplakia of cervix uteri (cervix), N89.4 — Leukoplakia of vagina (vagina), N89.8 — Other specified noninflammatory disorders of vagina (vagina), O08.0 — Genital tract and pelvic infection following ectopic and molar pregnancy (with ectopic or molar pregnancy), O86.19 — Other infection of genital tract following delivery (puerperal), Q52.79 — Other congenital malformations of vulva (adhesive, congenital), Q77.2 — Short rib syndrome (thoracic, asphyxiating), Q80.8 — Other congenital ichthyosis (universalis congenita), Q82.8 — Other specified congenital malformations of skin (pilaris), Q84.6 — Other congenital malformations of nails (nail, congenital), +84 more

Contextual Map

Every relationship of N90.4 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run N90.4 with this related code in Claim Check

Hierarchy

Referenced by Excludes2 notes

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 13 — Diseases and Disorders of the Female Reproductive System[MDC crossing]: “Diseases and Disorders of the Female Reproductive System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 2,238 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries (11)

  • Breisky's disease[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Disease, diseased, white-spot, meaning lichen sclerosus et atrophicus, vulva[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Dystrophy, dystrophia, vulva[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Hyperkeratosis, vulva[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Kraurosis, vulva[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Leukokraurosis vulva (e)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Leukoplakia, vulva[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Lichen, albus, vulva[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • and 3 more

Nearest codes (19)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (11)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 20, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "N90.4 — Leukoplakia of vulva." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/n90.4-leukoplakia-of-vulva

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Leukoplakia of vulva

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to N90.4 in its code family, with their registry titles.

View all codes in the N90 family