ICD-10 Coding for Pain with Intercourse(N94.11, N94.12)
Complete ICD-10-CM coding and documentation guide for Pain with Intercourse. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pain with Intercourse
N94.1-N94.19Primary Range
Dyspareunia and related conditions
This range covers various types of dyspareunia, including superficial and deep pain during intercourse.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N94.11 | Superficial dyspareunia | Use when pain is localized to the vaginal entrance during penetration. |
|
| N94.12 | Deep dyspareunia | Use when pain occurs with deep penetration or thrusting. |
|
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 pain with intercourse
Essential facts and insights about Pain with Intercourse
Primary ICD-10-CM Codes for pain with intercourse
Decision Criteria
clinical Criteria
- Pain at vaginal entrance during penetration
Applicable To
- Vulvodynia
- Vestibulitis
Excludes
- Deep dyspareunia (N94.12)
Clinical Validation Requirements
- Positive Q-tip test at vestibule
- Exclusion of infection
Code-Specific Risks
- Misclassification if pain is actually deep
Coding Notes
- Ensure documentation specifies location and nature of pain.
N94.12 - Deep dyspareunia
Use when pain occurs with deep penetration or thrusting.
Applicable To
- Pain with deep penetration
Excludes
- Superficial dyspareunia (N94.11)
Clinical Validation Requirements
- Laparoscopic confirmation of endometriosis
- MRI showing adhesions
Coding Notes
Document any underlying conditions contributing to deep dyspareunia.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other chronic pain
G89.29Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Pain with Intercourse to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N94.11.
Impact
Clinical: Inaccurate diagnosis and treatment planning., Regulatory: Potential for audit issues., Financial: Incorrect billing and reimbursement.
Mitigation Strategy
Train staff on detailed documentation, Use templates for consistency
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreased accuracy in clinical data.
Mitigation Strategy
Ensure documentation specifies whether pain is superficial or deep.
Impact
High risk of audits if unspecified codes are used without justification.
Mitigation Strategy
Ensure documentation supports the most specific code 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 Pain with Intercourse, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pain with Intercourse
Use these documentation templates to ensure complete and accurate documentation for Pain with Intercourse. These templates include all required elements for proper coding and billing.
Superficial dyspareunia
Specialty: GynecologyRequired Elements
- Pain location
- Pain quality
- Associated symptoms
- Physical exam findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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