ICD-10 Coding for Irregular Menstrual Cycle(N92.6, N92.5)
Complete ICD-10-CM coding and documentation guide for Irregular Menstrual Cycle. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Irregular Menstrual Cycle
N92.0-N92.9Primary Range
Excessive, frequent and irregular menstruation
This range covers various types of menstrual irregularities, including unspecified and specified 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 documentation lacks specifics about cycle length or associated symptoms. |
|
| N92.5 | Other specified irregular menstruation | Use when documentation specifies cycle length variations or specific types like oligomenorrhea. |
|
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 cycle
Essential facts and insights about Irregular Menstrual Cycle
Primary ICD-10-CM Codes for irregular menstrual cycle
Decision Criteria
documentation Criteria
- Documentation states 'irregular periods' without further detail
Applicable To
- Irregular periods without further specification
Clinical Validation Requirements
- Documentation states 'irregular periods' without further detail
- No test results confirming specific etiology
Code-Specific Risks
- Using this code when more specific information is available may lead to audits.
Coding Notes
- Ensure documentation supports the use of unspecified codes by confirming lack of specific details.
N92.5 - Other specified irregular menstruation
Use when documentation specifies cycle length variations or specific types like oligomenorrhea.
Applicable To
- Oligomenorrhea
- Polymenorrhea
Excludes
- Menorrhagia (N92.1)
Clinical Validation Requirements
- Cycle length <21 days or >35 days
- Intermenstrual bleeding
Coding Notes
Ensure documentation includes specific details about cycle irregularity.
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 Cycle to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N92.6.
Impact
Clinical: Leads to inappropriate treatment plans., Regulatory: Increases risk of non-compliance with coding standards., Financial: Results in claim denials or reduced reimbursement.
Mitigation Strategy
Ensure detailed documentation of menstrual history., Include specific cycle lengths and symptoms.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audits., Data Quality: Affects accuracy of clinical data.
Mitigation Strategy
Use N92.5 when specific cycle irregularities are documented.
Impact
Using N92.6 when specific details are available.
Mitigation Strategy
Ensure documentation includes specific cycle details to use N92.5.
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 Cycle, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Irregular Menstrual Cycle
Use these documentation templates to ensure complete and accurate documentation for Irregular Menstrual Cycle. These templates include all required elements for proper coding and billing.
Irregular menstrual cycle with pelvic pain
Specialty: OB/GYNRequired Elements
- Menstrual history
- Associated symptoms
- Diagnostic findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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