ICD-10 Coding for Irregular Menstruation(N92.6, N92.5)
Complete ICD-10-CM coding and documentation guide for Irregular Menstruation. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Irregular Menstruation
N92.0-N92.6Primary Range
Excessive, frequent, and irregular menstruation
This range covers various types of menstrual irregularities, including unspecified 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 | Irregular menstruation, unspecified | Use when cycles are irregular without identifiable cause or pattern. |
|
| N92.5 | Other specified irregular menstruation | Use when specific 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 irregular menstruation
Essential facts and insights about Irregular Menstruation
Primary ICD-10-CM Codes for irregular menstruation
Decision Criteria
clinical Criteria
- Irregular cycles without discernible pattern
coding Criteria
- No specific cause identified for irregularity
Applicable To
- Irregular cycles without discernible pattern
Clinical Validation Requirements
- Documentation of irregular cycles without identifiable pattern
- Menstrual intervals vary by more than 7 days
Code-Specific Risks
- Risk of using unspecified code when a more specific code is applicable.
Coding Notes
- Ensure documentation supports the use of an unspecified code.
N92.5 - Other specified irregular menstruation
Use when specific patterns are documented.
Applicable To
- Persistent intermenstrual bleeding
- Anovulatory cycles
Excludes
- Menorrhagia (N92.0)
- Metrorrhagia (N92.1)
Clinical Validation Requirements
- Documentation of specific patterns like persistent intermenstrual bleeding
Coding Notes
Ensure documentation specifies the pattern of 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 Menstruation 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 misdiagnosis., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Ensure detailed menstrual history is recorded., Use templates to guide documentation.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data for clinical research.
Mitigation Strategy
Use N92.4 (Excessive premenopausal bleeding) + N95.1 (Perimenopausal state).
Impact
High risk of audit if unspecified codes are used without supporting documentation.
Mitigation Strategy
Ensure detailed documentation and use 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 Irregular Menstruation, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Irregular Menstruation
Use these documentation templates to ensure complete and accurate documentation for Irregular Menstruation. These templates include all required elements for proper coding and billing.
Irregular Menstruation Evaluation
Specialty: GynecologyRequired Elements
- Menstrual history
- Cycle length and variability
- Associated symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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