CCSD code P1300 – Operations on the female perineum

Key takeaways

CCSD code P1300 covers surgery on the female perineal body, while vaginal wall, vulval and anal sphincter work each take their own code.

Bupa rates P1300 as MINOR 4, and AXA Health lists it as a minor procedure in sub-chapter 14.4 Vagina/perineum.

Third- and fourth-degree tears add a sphincter repair code, such as H5020, alongside P1300.

AXA Health lists P2310, P2930, P0910, P2932 and S5210 as unacceptable combinations with P1300.

Pabau, the practice software we build, sends UK claims through Healthcode and Bupa and warns you when a case has no pre-authorisation code.

What is CCSD Code P1300?

CCSD Code P1300 is the Clinical Coding and Schedule Development code for operations on the female perineum, used to bill UK private health insurers. AXA Health’s chapter 14 specialist schedule lists it under 14.4 Vagina/perineum as a minor procedure. It carries a £150 surgeon fee and £142 for general anaesthesia.

Bupa’s February 2026 schedule rates the same code MINOR 4, with a £166 fee. The CCSD Group maintains the code, and practices usually submit the claim through Healthcode.

The code serves both obstetric and elective work. An obstetrician repairing a tear after a private delivery uses P1300. So does a gynaecologist performing elective perineorrhaphy for prolapse-related symptoms. The documentation and pre-authorisation rules differ between the two, as the sections below show.

What P1300 covers: Procedures and clinical scope

The official descriptor, “Operations on female perineum”, covers surgery whose main anatomical site is the perineal body. That includes emergency obstetric repairs and planned reconstructive or functional gynaecological surgery.

The following procedures fall within P1300’s scope:

• Episiotomy repair: Suture closure of a surgical incision made to the perineum during delivery
• Perineal laceration repair: Surgical repair of obstetric perineal tears, graded first through fourth degree
• Perineorrhaphy: Repair and reconstruction of the perineal body, performed for prolapse, functional, or cosmetic-reconstructive indications
• Perineoplasty: Surgical reshaping or reconstruction of the perineum, including scar revision following previous perineal trauma
• Repair of perineal wound dehiscence: Closure of a previously repaired perineal wound that has broken down

The table below maps each procedure to its primary clinical indication, helping coders and billers confirm whether P1300 applies before submission.

What P1300 excludes: Adjacent codes and scope boundaries

P1300 applies only when the operative site is the perineal body itself. Procedures on anatomically adjacent structures use separate CCSD codes, and conflating these is a frequent source of incorrect submissions.

The following are not coded under P1300:

• Pelvic floor repair (anterior or posterior colporrhaphy): These are vaginal wall procedures with their own CCSD codes, P2230 and P2310. P1300 does not cover the vaginal mucosa or levator ani repair unless the operative note confirms extension to the perineal body.
• Vulval procedures: Vulvoplasty, labial reduction, and excision of vulval lesions use separate codes in the vulva/labia sub-chapter, such as P0550 and P0600.
• Urethral procedures: Urethral dilatation, urethrotomy, and periurethral bulking agents are coded independently.
• Anal sphincter repair (OASI repair): Third- and fourth-degree tears involve the anal sphincter complex. The sphincter repair takes its own code alongside P1300, so confirm it against the insurer’s coding guide.

When a procedure involves both the perineum and an adjacent structure, review whether both codes can be billed simultaneously or whether bundling rules apply. See the section on billing P1300 alongside other CCSD codes below.

A fistula between the bladder and the vagina is not a perineal operation, and it is coded P2510. Repair of a urethrovaginal fistula is coded CCSD P2520 instead. Reconstruction of the vagina itself has its own code, P2100. Repair of the vaginal vault falls in the P24 range, which includes CCSD P2420.

Coding episiotomy repair and obstetric perineal trauma under CCSD Code P1300

Obstetric perineal trauma is graded by degree, and that grading directly affects how the operative note must be written to support a P1300 claim. The table below summarises the degree classification and the corresponding documentation requirements.

P1300 applies to the perineal repair in all four degrees. For third- and fourth-degree tears, the sphincter repair is billed separately, and the schedule lists repair of anal sphincter as H5020. Insurers may audit a claim whose operative note describes sphincter involvement but which carries P1300 alone.

Coding perineorrhaphy and elective perineal procedures under P1300

Elective perineal procedures present a different documentation challenge. An obstetric repair is an emergency with a clear clinical indication. Elective perineorrhaphy and perineoplasty need an operative note that establishes medical necessity beyond cosmetic intent.

Key distinctions to capture in the clinical record for elective P1300 procedures:

• Indication: State whether the surgery addresses functional symptoms (pelvic pressure, dyspareunia, difficulty with hygiene), prolapse-related perineal descent, or scar revision after obstetric trauma. The indication determines whether the procedure is classified as reconstructive (covered by most insurers) or cosmetic (typically excluded).
• Operative findings: Document the pre-operative perineal assessment, degree of perineal descent, presence of scar tissue, and anatomical landmarks encountered intraoperatively.
• Technique: Record the specific surgical technique, suture layers, suture material, and whether any mesh or graft material was used.
• Anaesthetic type: State whether the procedure was performed under general anaesthesia, spinal, or local anaesthetic with sedation. This affects the total claim and may need a separate anaesthetist code.

Perineoplasty performed mainly for cosmetic reasons is frequently excluded from private health insurance cover. Where there is any cosmetic component, get written pre-authorisation that confirms cover before the procedure. A standard approval for P1300 as a category does not settle it.

Documentation requirements for P1300 claims

A complete operative note is the foundation of a successful P1300 claim. Missing or vague documentation is a common cause of insurer queries and payment delays. A structured operative note template captures every required field before the case closes.

The operative note for a P1300 claim must include all of the following:

• Procedure performed (using the CCSD descriptor where possible)
• Anatomical site (perineal body; note extension to adjacent structures if applicable)
• Clinical indication (obstetric tear degree, or elective indication with symptom description)
• Operative findings (pre-repair assessment, structures involved)
• Repair technique (suture layers, suture material, interrupted or continuous)
• Anaesthetic type (general, spinal, regional, or local)
• Surgeon’s name and GMC number
• Date and location of procedure
• Estimated blood loss and any complications noted

For Healthcode submissions, enter the CCSD code accurately in the procedure field, with the correct consultant code and insurer membership number. One common rejection has nothing to do with clinical coding. The consultant code on the Healthcode submission does not match the insurer’s recognition records.

Pre-authorisation requirements for P1300 from private health insurers

Pre-authorisation requirements for perineal procedures vary by insurer and by whether the procedure is obstetric or elective. The table below summarises the general position of the main UK private health insurers. Policies change, so verify current requirements with each payer before treating.

An elective P1300 pre-authorisation request should include:

• The clinical indication and the proposed CCSD code
• The consultant’s name and GMC number
• The proposed treatment date
• The referring GP’s details

Insurers may also request a brief letter of medical necessity for perineoplasty or perineorrhaphy where the indication is not straightforwardly reconstructive.

Common reasons P1300 claims are denied and how to avoid them

Claim denials for P1300 follow predictable patterns. Most can be prevented with the right documentation habits and a pre-submission checklist. The table below lists the most frequent denial reasons and the specific fix for each.

Codes frequently confused with CCSD Code P1300

Several CCSD codes cover neighbouring anatomy and get submitted in error when P1300 is correct, or the reverse. Confirm current descriptors with the insurer’s schedule before submission. The CCSD technical guide (October 2025) explains how the schedule is structured. Our CCSD codes reference covers more of the neighbouring codes.

Can P1300 be billed alongside other CCSD codes?

Yes, P1300 can go on the same claim as another CCSD code when each code reflects a distinct procedure. Bundling all perineal and pelvic work under P1300 is wrong. So is itemising every step of a single repair as its own code.

Codes that may legitimately be billed alongside P1300:

• Anal sphincter repair: Where the operative note confirms a third- or fourth-degree tear, the sphincter repair is a distinct procedure. It carries its own CCSD code.
• Posterior colporrhaphy: When a planned perineorrhaphy also involves posterior vaginal wall repair, P2230 may be coded separately. The operative note has to describe it as a distinct component, with its own technique and suture layers.
• Anaesthesia: The anaesthetist’s fees are submitted under the relevant anaesthesia code(s) and are not bundled into P1300.

Codes that are likely to conflict with P1300:

• Insurer-listed unacceptable combinations: AXA Health does not accept P2310, P2930, P0910, P2932 or S5210 billed with P1300. They cover combined colporrhaphy, vaginal and vulval biopsy, examination under anaesthetic, and trigger point injection.
• Episiotomy repair and perineorrhaphy from the same session: If both happen as one continuous repair, submitting P1300 twice may trigger a bundling query. The operative note must clearly describe two distinct procedures to support two lines.
• Minor wound care codes: Post-operative wound reviews and dressing changes are not separately billable alongside a surgical repair code in most insurer fee schedules.

The P2310 conflict matters most in prolapse surgery. A combined anterior and posterior repair that also repairs the perineal body goes to AXA Health without a separate P1300 line.

When in doubt, check the insurer’s fee schedule and unbundling rules. The Healix fee schedule includes specific guidance on unbundling and multiple procedure billing that reflects common practice across UK private health insurers.

How Pabau supports P1300 claims and pre-authorisation

The denial reasons above trace back to three manual steps: choosing the code, writing the operative note and recording the pre-authorisation reference. In a paper workflow, each step happens in a different place, so a mismatch surfaces only when the insurer queries the claim.

Pabau, the practice management platform we build, keeps the operative note and the claim on one patient record. Its claims management software sends UK claims through Healthcode and Bupa. Nobody re-keys the procedure from the note into a separate billing system.

Pre-authorisation is tracked on the case, with the authorisation code, dates and sessions recorded. Pabau warns you when a case has no authorisation code, which heads off the first denial in the table above. For practices billing mainly to Bupa, our Bupa CCSD procedure codes guide covers the wider schedule.

Manage CCSD billing without the manual overhead

Pabau sends UK claims through Healthcode and Bupa from the patient record, and warns you when a case has no pre-authorisation code. See how it fits a gynaecology practice.

Book a demo

Conclusion

Treat the operative note as the claim. Record the degree of tear, the exact operative site and any sphincter work on the day, and the code choice follows from it.

Check the insurer’s combination rules before you add a second code. AXA Health does not accept P1300 next to P2310 and four other codes, while a sphincter repair is billed separately. Elective cases need their pre-authorisation reference on file before the procedure. Book a demo to see how Pabau keeps the operative note, pre-authorisation and Healthcode claim on one record.

Continue your research

Repairing a rectal prolapse through the perineum? CCSD code H4200 covers perineal repair of prolapse of rectum.

Frequently asked questions