ICD-10 Coding for Hot Flash(N95.1, R23.2)
Complete ICD-10-CM coding and documentation guide for Hot Flash. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hot Flash
N95-N99Primary Range
Menopausal and other perimenopausal disorders
This range includes codes for menopausal symptoms, including hot flashes.
Symptoms and signs involving the skin and subcutaneous tissue
This range includes codes for general symptoms like flushing, which can be used if hot flashes are not menopausal.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N95.1 | Menopausal and female climacteric states | Use when hot flashes are due to menopause. |
|
| R23.2 | Flushing | Use when flushing is due to non-menopausal causes. |
|
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 menopausal hot flashes
Essential facts and insights about Hot Flash
Primary ICD-10-CM Codes for hot flash
Decision Criteria
clinical Criteria
- Menopausal symptoms with lab confirmation
coding Criteria
- Documented absence of other causes
Applicable To
- Vasomotor symptoms of menopause
- Hot flashes due to menopause
Excludes
- Flushing not related to menopause
Clinical Validation Requirements
- FSH >30 mIU/mL
- Estradiol <30 pg/mL
- ≥12 months amenorrhea
Code-Specific Risks
- Confusion with R23.2 if menopausal status is not documented.
Coding Notes
- Ensure menopausal status is documented to use N95.1.
R23.2 - Flushing
Use when flushing is due to non-menopausal causes.
Applicable To
- General flushing
Excludes
- Menopausal hot flashes
Clinical Validation Requirements
- Documented cause of flushing if non-menopausal
Coding Notes
Always check for underlying causes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hot Flash to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N95.1.
Impact
Clinical: Misrepresentation of patient's condition., Regulatory: Potential audit risk., Financial: Incorrect billing and reimbursement.
Mitigation Strategy
Always document menopausal status in patient records.
Impact
Reimbursement: Incorrect reimbursement due to wrong DRG assignment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure menopausal status is documented and use N95.1.
Impact
Lack of documentation for menopausal status when using N95.1.
Mitigation Strategy
Ensure all menopausal symptoms are documented with lab results.
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 Hot Flash, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hot Flash
Use these documentation templates to ensure complete and accurate documentation for Hot Flash. These templates include all required elements for proper coding and billing.
Menopausal Hot Flashes
Specialty: GynecologyRequired Elements
- Last menstrual period
- FSH/Estradiol results
- Hot flash frequency and duration
- Associated symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Hot Flash? Ask your questions below.