ICD-10 Coding for Abnormal Menses(N92.6, N92.5)
Complete ICD-10-CM coding and documentation guide for Abnormal Menses. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Abnormal Menses
N92Primary Range
Excessive, frequent and irregular menstruation
This range covers various types of abnormal menstrual bleeding patterns, including unspecified, excessive, and irregular menstruation.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N92.6 | Unspecified irregular menstruation | Use when the patient presents with irregular menstruation but lacks specific details or diagnosis. |
|
| N92.5 | Other specified irregular menstruation | Use when specific irregular bleeding patterns are documented. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for unspecified irregular menstruation
Essential facts and insights about Abnormal Menses
Primary ICD-10-CM Codes for abnormal menses
Decision Criteria
clinical Criteria
- Patient reports irregular periods without specific pattern
documentation Criteria
- Lack of specific menstrual pattern details
Applicable To
- Irregular periods without further specification
Clinical Validation Requirements
- Patient reports irregular periods without specific pattern
- No specific underlying cause identified
Code-Specific Risks
- Risk of under-coding if more specific information is available
Coding Notes
- Ensure documentation supports the lack of specificity before using this code.
N92.5 - Other specified irregular menstruation
Use when specific irregular bleeding patterns are documented.
Applicable To
- Metrorrhagia
- Intermenstrual bleeding
Excludes
- Menorrhagia (N92.0)
Clinical Validation Requirements
- Documented specific irregular bleeding pattern
- Supporting lab or imaging findings
Coding Notes
Ensure specific bleeding patterns are documented to support this code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Abnormal Menses to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N92.6.
Impact
Clinical: May lead to incorrect diagnosis and treatment, Regulatory: Increased risk of audit issues, Financial: Potential for reduced reimbursement
Mitigation Strategy
Ensure detailed documentation of menstrual patterns, Use templates to guide comprehensive history taking
Impact
Reimbursement: Potential underpayment due to lack of specificity, Compliance: Risk of audit failure for lack of detailed documentation, Data Quality: Decreased accuracy in clinical data
Mitigation Strategy
Ensure documentation includes specific menstrual irregularities to use N92.5.
Impact
Frequent use of unspecified codes without supporting documentation
Mitigation Strategy
Encourage detailed documentation and use of specific codes when possible.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Abnormal Menses, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Abnormal Menses
Use these documentation templates to ensure complete and accurate documentation for Abnormal Menses. These templates include all required elements for proper coding and billing.
Irregular Menstrual Cycle Evaluation
Specialty: GynecologyRequired Elements
- Menstrual history
- Cycle length and variability
- Bleeding duration and intensity
- Associated symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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