ICD-10 Coding for Abnormal Period(N92.1, N92.5)
Complete ICD-10-CM coding and documentation guide for Abnormal Period. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Abnormal Period
N92-N93Primary Range
Excessive, frequent and irregular menstruation
This range includes codes for various types of abnormal uterine bleeding, which are central to diagnosing and coding abnormal periods.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N92.1 | Excessive and frequent menstruation with irregular cycle | Use when a patient presents with heavy bleeding and irregular cycles. |
|
| N92.5 | Other specified irregular menstruation | Use for irregular cycles with a documented cause but not heavy bleeding. |
|
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 abnormal periods
Essential facts and insights about Abnormal Period
Primary ICD-10-CM Codes for abnormal period
Decision Criteria
clinical Criteria
- Documented heavy bleeding with irregular cycles
Applicable To
- Menorrhagia with irregular cycles
Excludes
- Postmenopausal bleeding (N95.0)
Clinical Validation Requirements
- PBAC >100
- Hgb <12 g/dL
- Cycle variability >8 days
Code-Specific Risks
- Undercoding if specific cycle details are not documented.
Coding Notes
- Ensure documentation specifies cycle length and flow intensity.
N92.5 - Other specified irregular menstruation
Use for irregular cycles with a documented cause but not heavy bleeding.
Applicable To
- Irregular menstruation with specified cause
Excludes
- Menorrhagia (N92.0)
Clinical Validation Requirements
- Cycle variability >7 days
- Documented cause such as post-D&C
Coding Notes
Ensure irregularity is specified with cycle length.
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 Period to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N92.1.
Impact
Clinical: Leads to inappropriate treatment plans., Regulatory: Increases risk of audit and non-compliance., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Use structured templates for menstrual history., Ensure detailed documentation of cycle patterns.
Impact
Reimbursement: Potential for reduced reimbursement due to lack of specificity., Compliance: Increased risk of audit due to non-specific coding., Data Quality: Decreased data quality and accuracy in patient records.
Mitigation Strategy
Document specific cycle irregularities and bleeding patterns to use N92.1 or N92.5.
Impact
Risk of audits due to use of unspecified codes.
Mitigation Strategy
Ensure detailed documentation supports specific code selection.
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 Period, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Abnormal Period
Use these documentation templates to ensure complete and accurate documentation for Abnormal Period. These templates include all required elements for proper coding and billing.
OB/GYN Visit for Menstrual Irregularity
Specialty: GynecologyRequired Elements
- Menstrual history
- Cycle length and variability
- Flow intensity and duration
- Associated symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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