Laceration with foreign body of vagina and vulva, sequela

This code describes a past injury to the external female genitalia and/or vagina that involved a cut or tear with a foreign object embedded, and the patient is now experiencing a long-term complication or residual effect from that original injury. This could include chronic pain, scarring, fistula formation, or other persistent issues directly attributable to the laceration and foreign body.

Use this code when documenting follow-up care for a patient presenting with a current problem or condition that is a direct consequence of a previously sustained laceration of the vagina and/or vulva with a foreign body. This applies to situations where the initial acute injury has resolved, but its lasting impact is being addressed. Examples include evaluation of chronic dyspareunia following a past foreign body laceration or surgical repair of a persistent scar contracture.

• Always assign an additional code to specify the nature of the sequela (e.g., chronic pain, scar, fistula).
• Ensure documentation clearly links the current condition to the historical laceration with a foreign body.
• Do not use this code for the initial acute injury; use the appropriate acute injury code with the initial encounter or subsequent encounter seventh character.