CCSD code P2310 – Anterior and posterior colporrhaphy

Key takeaways

CCSD code P2310 is anterior +/- posterior colporrhaphy (including primary repair of enterocele) (including cystoscopy), in CCSD section 14.4 Vagina/Perineum.

Primary enterocele repair and same-episode cystoscopy are inside P2310, so neither goes on the claim as a second line.

CCSD lists M4510, M4514, P1300, P2210, P2230, P2340, Q0830 and Q0890 as unacceptable combinations with P2310.

Colporrhaphy done with a vaginal hysterectomy has its own codes, P2380 and P2390, rather than P2310 plus a hysterectomy code.

CCSD codes carry no modifiers, so get pre-authorisation for the exact code and make the operative note match it.

CCSD code P2310 is anterior +/- posterior colporrhaphy, with cystoscopy built in

CCSD code P2310 is the UK private-practice code for anterior +/- posterior colporrhaphy (including primary repair of enterocele) (including cystoscopy). The surgeon repairs the front vaginal wall, and the back wall too where needed. In addition, a first-time enterocele repair and any cystoscopy in the same case are part of the code.

The code sits in Chapter 14 of the CCSD schedule, Female reproductive organs, in section 14.4 Vagina/Perineum. The Clinical Coding and Schedule Development Group maintains the schedule. UK private insurers such as Bupa, AXA Health, Aviva and Vitality use it, and you can find neighbouring CCSD codes in our code library.

Read the “+/-” in the descriptor carefully. P2310 fits an anterior repair on its own, or an anterior repair with a posterior repair in the same surgery. However, a posterior repair with no anterior repair is a different code, P2230.

What P2310 covers, and what it doesn’t

First, anterior colporrhaphy corrects a cystocele, where the bladder bulges into the front vaginal wall. Posterior colporrhaphy, in contrast, corrects a rectocele in the back wall. Finally, an enterocele is small bowel herniating into the upper vagina. A fistula between the bladder and the vagina is a different repair, coded P2510. One between the urethra and the vagina is coded P2520. Rebuilding the vagina itself, rather than repairing a wall, is billed as P2100.

P2310 includes:

• Repair of the anterior vaginal wall, with plication of the supporting fascia.
• Repair of the posterior vaginal wall in the same surgery, where the surgeon performs one.
• Primary repair of an enterocele that the surgeon finds and closes during surgery.
• Cystoscopy in the same case, for example to check the bladder after the anterior repair.

P2310 does not cover:

• A posterior repair on its own, which is P2230.
• Colporrhaphy with amputation of the cervix, as in a Manchester repair, which is P2210.
• An enterocele repair as the main procedure, with or without posterior repair, which is P2340.
• Colporrhaphy with vaginal hysterectomy, which is P2380, or P2390 with laparoscopic assistance.

The word “primary” matters. CCSD names primary enterocele repair inside P2310 and says nothing about a recurrent one. So if the enterocele has come back after earlier surgery, ask the insurer how it wants the case coded before you submit.

Neighbouring vaginal repair codes are where coders slip

The usual P2310 error is choosing a code one row away in section 14.4. The descriptors and bands below come from AXA Health’s published CCSD-based specialist schedule, which we checked in November 2026. However, P2390 is not on AXA’s schedule, so its descriptor comes from National Friendly’s schedule of fees.

Ask three questions about the operative note, in the order below, and the choice settles itself.

Our M4510 billing guide covers flexible cystoscopy when it is the only procedure. However, once the scope is part of a colporrhaphy, it belongs to P2310.

Some codes can never share a claim with P2310

First, CCSD lists unacceptable combinations for P2310. If you bill one of these beside it in the same case, the insurer will reject the line or cut it back to a single code.

• M4510 and M4514. Flexible or rigid diagnostic cystoscopy, already in the P2310 descriptor.
• P1300. Operations on female perineum, so a perineal procedure at the same sitting stays off the claim.
• P2210, P2230 and P2340. The other colporrhaphy and enterocele codes, which overlap with the repair P2310 already describes.
• Q0830 and Q0890. Vaginal hysterectomy codes. For a colporrhaphy done with a vaginal hysterectomy, bill P2380 or P2390 instead.

In fact, AXA Health’s own list for P2310 goes further. It also blocks P2380, Q0800 (vaginal hysterectomy without laparoscopic assistance), and the bladder outlet support codes M5100 and M5300. Each insurer decides which combinations it adopts, so check the payer’s list before you add a second code.

Match the ICD-10 code to each compartment repaired

UK insurers use WHO ICD-10, not the US ICD-10-CM, so the N81 female genital prolapse category holds the codes that often support a P2310 claim.

So, code each compartment the note records. For example, a combined cystocele and rectocele repair carries N81.1 and N81.6, with N81.5 added if the surgeon closed an enterocele. Then quote the same codes on the approval request and the invoice.

The operative note has to show which walls were repaired

Insurers read the operative note against the descriptor. For example, a note that says only “pelvic floor repair” doesn’t show that the front wall was repaired, so the claim gets queried. Where the note describes a repair of the perineal body alone, the code is P1300 instead.

For P2310, the operative note should record:

• Compartments repaired. Name the anterior wall, and the posterior wall if the surgeon repaired it, in plain words.
• Enterocele. Whether one was found, and that the repair was a primary one.
• Cystoscopy findings. Record what the scope showed as part of the same procedure.
• Indication. The prolapse diagnosis, with the ICD-10 codes your insurer asks for.
• Cervix and uterus. That the surgeon did not amputate the cervix or remove the uterus, which rules out P2210 and P2380.
• Any extra procedures. Name each one on its own line, so the insurer can check it against the unacceptable combinations.

Pre-authorisation comes before the surgery date is booked

Colporrhaphy is planned surgery, so the patient’s insurer must authorise it before the hospital stay. UK insurers expect members to call before any planned surgery. Our guide to Bupa CCSD codes covers how Bupa handles recognition and fees.

Next, here is what the approval request should carry:

• The exact CCSD code, P2310, or P2380 if a vaginal hysterectomy is planned as well.
• The prolapse diagnosis and exam findings, such as the POP-Q stage.
• The admission date, the hospital and the treating consultant.
• Any second procedure you expect to bill, so the insurer can flag a combination it won’t pay.

If the plan changes in theatre, call the insurer afterwards and have the insurer amend the approval. Otherwise, a claim that uses a different code from the authorised one often stalls payment.

How a P2310 claim moves from surgery to payment

Because a colporrhaphy produces several invoices from one hospital stay, each party then bills its own part against the same procedure code.

1. The surgeon invoices the procedure fee under P2310, quoting the approval number.
2. The anaesthetist invoices the anaesthetic fee for the same procedure code.
3. The hospital bills the facility costs, such as theatre time, the bed and drugs, under its own agreement with the insurer.

Specialist invoices often go online through Healthcode or the insurer’s own portal. However, fees depend on the insurer and your recognition status. For example, AXA Health’s contracted schedule lists P2310 at £570 for the procedure and £285 for anaesthesia, as we checked in November 2026.

For a self-pay patient, though, your own fee schedule applies, and P2310 is just the reference on the invoice. For an insured patient, however, check the insurer’s shortfall rules before billing the patient for any difference.

A worked example shows where the code choice is made

Take a sample case. A patient has a symptomatic cystocele and rectocele, with a small enterocele seen at the exam. The consultant plans an anterior and posterior repair and obtains pre-authorisation for P2310.

First, in theatre, the surgeon repairs both walls and closes the enterocele sac. Next, a cystoscopy after the anterior repair confirms the bladder is intact. Finally, the operative note records all three steps.

As a result, the surgeon bills P2310 alone, with N81.1, N81.6 and N81.5 as the diagnoses. The cystoscopy stays off the claim because M4514 is an unacceptable combination. In contrast, had the surgeon also removed the uterus vaginally, the code would have been P2380.

Run this checklist before you submit

• The operative note states that the anterior wall was repaired.
• No cervical amputation or hysterectomy is recorded, or the code moves to P2210, P2380 or P2390.
• The approval number is on the invoice and covers P2310.
• No M4510, M4514, P1300, P2210, P2230 or P2340 line appears beside P2310.
• No Q0830 or Q0890 line appears beside it either.
• The insurer has cleared any other second procedure as an acceptable combination.
• The consultant’s insurer recognition was current on the date of surgery.

Why insurers deny or short-pay P2310 claims

When a P2310 claim fails, the reason is often one of these.

• No valid approval. Surgery went ahead without it, or after it expired.
• Code and approval don’t match. The invoice says P2310 and the approval says P2380, or the reverse.
• Unacceptable combination. The invoice carried a cystoscopy, posterior repair or enterocele code in the same case.
• Posterior-only repair billed as P2310. Without an anterior repair, the code is P2230.
• Recognition problems. The insurer didn’t recognise the consultant on the date of surgery.

You can often appeal these with the operative note. To do so, write a short cover letter that ties the evidence to the descriptor.

How Pabau keeps P2310 claims complete

When a colporrhaphy claim stalls, the cause is often paperwork. For example, the approval sits in an email, the operative note sits in the hospital system, and the invoice gets typed up days later.

Pabau, the practice management platform we build, instead keeps those pieces on one patient record. Its clinical records hold the operative note and exam findings, and digital forms collect consent before the hospital stay. Your invoice to the insurer comes from that record, and Pabau’s claims management software then sends it through Healthcode.

As a result, you get fewer queries about missing numbers and quicker payment for your surgical work.

Send every P2310 claim with its proof attached

Pabau keeps authorisation numbers, consent and operative notes on one record, then sends the insurer invoice through Healthcode.

Book a demo

Conclusion

P2310 is a vaginal repair code with a precise descriptor. So bill it when the front wall was repaired, with or without the back wall, and no cervix or uterus came out. Keep the cystoscopy and the enterocele repair off the claim as separate lines.

Also, get the approval for the same code you will invoice, and make the operative note name each wall repaired. Do both, and the insurer has no paperwork reason left to query the claim.

Book a demo to see how Pabau keeps each surgery claim and its proof on one patient record.

Continue your research

Need the full Bupa coding picture? Bupa CCSD codes explains how the CCSD schedule works with Bupa claims, recognition and fees.

Was the enterocele the main surgery? CCSD code P2340 covers enterocele repair as a sole procedure.

Was it a diagnostic cystoscopy only? CCSD code M4510 covers flexible cystoscopy and when a biopsy stays inside the code.

Is bladder outlet surgery planned in the same case? CCSD code M5100 covers combined abdominal and vaginal bladder outlet surgery.

Frequently asked questions