ICD-10 Coding for Missed Period(N91.0, N91.1)
Complete ICD-10-CM coding and documentation guide for Missed Period. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Missed Period
N91.0-N91.2Primary Range
Amenorrhea
This range covers primary and secondary amenorrhea, which are the main conditions associated with missed periods.
Pregnancy test positive
Used to indicate a positive pregnancy test, which can be a reason for a missed period.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N91.0 | Primary amenorrhea | Use when a patient aged 15 or older has not experienced menarche despite normal pubertal development. |
|
| N91.1 | Secondary amenorrhea | Use for patients with a history of menstruation who have not menstruated for three months or more. |
|
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 missed period
Essential facts and insights about Missed Period
Primary ICD-10-CM Codes for missed period
Decision Criteria
clinical Criteria
- Patient age and absence of menarche
Applicable To
- Absence of menarche by age 15
Excludes
- Secondary amenorrhea
Clinical Validation Requirements
- Patient age ≥15 years
- No menarche despite normal puberty development
Code-Specific Risks
- Incorrect use for secondary amenorrhea
Coding Notes
- Ensure documentation specifies primary amenorrhea and excludes secondary causes.
N91.1 - Secondary amenorrhea
Use for patients with a history of menstruation who have not menstruated for three months or more.
Applicable To
- Absence of menstruation for ≥3 months
Excludes
- Primary amenorrhea
- Pregnancy
Clinical Validation Requirements
- Absence of menstruation for ≥3 months
- Exclusion of pregnancy, breastfeeding, and menopause
Coding Notes
Ensure documentation includes negative pregnancy test results.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Pregnancy test positive
Z32.01Differential 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 Missed Period to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N91.0.
Impact
Clinical: Impacts diagnosis accuracy, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Always record LMP in patient history, Use templates to ensure completeness
Impact
Reimbursement: May affect DRG assignment and payment rates., Compliance: Increases risk of audit and non-compliance., Data Quality: Leads to inaccurate clinical data.
Mitigation Strategy
Ensure documentation specifies primary or secondary amenorrhea.
Impact
Using N91.2 without specifying primary or secondary amenorrhea.
Mitigation Strategy
Educate providers on documentation requirements.
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 Missed Period, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Missed Period
Use these documentation templates to ensure complete and accurate documentation for Missed Period. These templates include all required elements for proper coding and billing.
Amenorrhea Evaluation
Specialty: GynecologyRequired Elements
- Menstrual history
- Pregnancy test results
- Endocrine panel results
- Imaging findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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