ICD-10 Coding for Irregular Menstrual Bleeding(N92.6, N92.5)
Complete ICD-10-CM coding and documentation guide for Irregular Menstrual Bleeding. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Irregular Menstrual Bleeding
N92-N93Primary Range
Excessive, frequent and irregular menstruation
This range includes codes for various types of menstrual irregularities, including excessive, frequent, 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 menstrual irregularity is documented without specific details or identified cause. |
|
| N92.5 | Other specified irregular menstruation | Use when specific irregularities like oligomenorrhea or polymenorrhea 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 irregular menstrual bleeding
Essential facts and insights about Irregular Menstrual Bleeding
Primary ICD-10-CM Codes for irregular menstrual bleeding
Decision Criteria
clinical Criteria
- Irregular cycles without specific pattern or cause
Applicable To
- Irregular menstruation NOS
Excludes
- N92.5 (Other specified irregular menstruation)
Clinical Validation Requirements
- Documented irregular menstrual cycles without specific etiology
- Absence of specific cycle pattern or cause
Code-Specific Risks
- Overuse of unspecified codes can lead to audit risks.
Coding Notes
- Ensure documentation specifies the lack of specific cycle pattern or cause.
N92.5 - Other specified irregular menstruation
Use when specific irregularities like oligomenorrhea or polymenorrhea are documented.
Applicable To
- Oligomenorrhea
- Polymenorrhea
Excludes
- N92.6 (Unspecified irregular menstruation)
Clinical Validation Requirements
- Documented cycle irregularities with specific characteristics
- Identified etiology such as PCOS
Coding Notes
Ensure documentation includes specific cycle irregularities and any identified etiology.
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 Irregular Menstrual Bleeding 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 inappropriate treatment decisions., Regulatory: Increases risk of audit findings., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Use structured templates for menstrual history, Train staff on documentation requirements
Impact
Reimbursement: May affect reimbursement accuracy., Compliance: Increases audit risk., Data Quality: Reduces specificity of clinical data.
Mitigation Strategy
Use N92.5 if specific cycle irregularities are documented.
Impact
Frequent use of unspecified codes like N92.6 can trigger audits.
Mitigation Strategy
Encourage detailed documentation and use of specific codes.
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 Irregular Menstrual Bleeding, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Irregular Menstrual Bleeding
Use these documentation templates to ensure complete and accurate documentation for Irregular Menstrual Bleeding. These templates include all required elements for proper coding and billing.
Irregular menstrual cycles with identified cause
Specialty: GynecologyRequired Elements
- Cycle length and variability
- Duration and flow characteristics
- Associated symptoms
- Identified etiology
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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