O70.4 Anal sphincter tear complicating delivery, not associated with third degree laceration

Billable ICD-10-CM code, FY2026. Acts as a Complication or Comorbidity (CC) as a secondary diagnosis.

Excludes1 (never code together)

• anal sphincter tear with third degree perineal laceration (O70.2-)

Applies from O70 Perineal laceration during delivery

Includes

• episiotomy extended by laceration

Excludes1 (never code together)

• obstetric high vaginal laceration alone (O71.4)

MS-DRG index

Defines the logic of DRG(s) 769 in MDC 14.

Approximate ICD-9-CM (GEMs)

• 664.61 Anal sphincter tear complicating delivery, not associated with third-degree perineal laceration, delivered, with or without mention of antepartum condition (approximate)
• 664.64 Anal sphincter tear complicating delivery, not associated with third-degree perineal laceration, postpartum condition or complication (approximate)

Medicare Code Edits (MCE v43.1 (April 2026))

• Maternity diagnoses (age 9 through 64): Age conflict edit. These diagnoses are clinically expected only in patients age 9 through 64.

Code annotations containing back-references to O70.4

Back-references to O70.4

• Type 1 Excludes: O70.2 Third degree perineal laceration during delivery ("anal sphincter tear during delivery without third degree perineal laceration (O70.4)")

Back-references to O70

• Type 1 Excludes: N89.8 Other specified noninflammatory disorders of vagina ("current obstetric trauma (O70.-, O71.4, O71.7-O71.8)")
• Type 1 Excludes: N90 Other noninflammatory disorders of vulva and perineum ("current obstetric trauma (O70.-, O71.7-O71.8)")
• Type 1 Excludes: O71.4 Obstetric high vaginal laceration alone ("obstetric high vaginal laceration with perineal laceration (O70.-)")
• Type 1 Excludes: S31.4 Open wound of vagina and vulva ("injury to vagina and vulva during delivery (O70.-, O71.4)")

Diagnosis Index entries for O70.4

• Delivery (childbirth) (labor) › complicated › by › laceration (perineal) › anus (sphincter)
• Delivery (childbirth) (labor) › complicated › by › laceration (perineal) › anus (sphincter) › without third degree laceration
• Tear, torn (traumatic) › anus, anal (sphincter) › complicating delivery › without third degree perineal laceration

Nearby codes

• O70.20 Third degree perineal laceration during delivery, unspecified
• O70.21 Third degree perineal laceration during delivery, IIIa
• O70.22 Third degree perineal laceration during delivery, IIIb
• O70.23 Third degree perineal laceration during delivery, IIIc
• O70.3 Fourth degree perineal laceration during delivery
• O70.4 Anal sphincter tear complicating delivery, not associated with third degree laceration (this code)
• O70.9 Perineal laceration during delivery, unspecified