Ulceration of vulva in diseases classified elsewhere

This code describes the presence of an ulceration on the vulva that is a manifestation of an underlying systemic disease or condition, rather than a primary vulvar infection. It indicates a secondary vulvar ulceration where the primary etiology is classified to another chapter of ICD-10-CM.

Use this code when documentation specifies a vulvar ulceration that is clearly attributed to a systemic disease, such as Crohn's disease, Behçet's disease, or a dermatological condition like pemphigus, and the underlying disease is coded separately. The medical record should explicitly link the vulvar ulceration to the "disease classified elsewhere."

• Always sequence the underlying systemic disease code first, as N77.0 is a manifestation code.
• Carefully review documentation to ensure the vulvar ulceration is indeed secondary to a systemic condition and not a primary vulvar infection.
• Pay close attention to the Excludes1 notes to avoid incorrect coding when the ulceration is due to specific infectious agents like gonorrhea, herpes, syphilis, or tuberculosis.