ICD-10 Coding for Painful Intercourse(N94.11, N94.12)
Complete ICD-10-CM coding and documentation guide for Painful Intercourse. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Painful Intercourse
N94.1-N94.19Primary Range
Dyspareunia and related conditions
This range includes codes for different types of dyspareunia, which is the primary condition being documented.
Vaginismus
Vaginismus is a differential diagnosis that can present with similar symptoms to dyspareunia.
Pelvic and perineal pain
This code is used for ancillary documentation of pelvic pain not directly related to 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. |
|
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 painful intercourse
Essential facts and insights about Painful Intercourse
Primary ICD-10-CM Codes for painful intercourse
Decision Criteria
clinical Criteria
- Pain localized to vaginal entrance
Applicable To
- Pain at vaginal entrance during penetration
Excludes
- Deep dyspareunia (N94.12)
Clinical Validation Requirements
- Sharp pain at vaginal opening with tampon insertion
- Q-tip test positive at vestibule
Code-Specific Risks
- Misclassification if pain is actually deep
Coding Notes
- Ensure documentation specifies superficial pain to avoid incorrect coding.
N94.12 - Deep dyspareunia
Use when pain occurs with deep penetration.
Applicable To
- Pain with deep thrusting
Excludes
- Superficial dyspareunia (N94.11)
Clinical Validation Requirements
- Deep pelvic pain in missionary position, worsens with cervical motion
- Cervical motion tenderness
Coding Notes
Document specific deep pain characteristics to ensure correct coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Pelvic and perineal pain
R10.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Painful 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: Leads to misdiagnosis and inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Include detailed pain characteristics and location in notes.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient care.
Mitigation Strategy
Specify whether the dyspareunia is superficial (N94.11) or deep (N94.12).
Impact
Failure to specify superficial or deep dyspareunia can lead to audit issues.
Mitigation Strategy
Ensure documentation clearly differentiates between superficial and deep pain.
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 Painful Intercourse, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Painful Intercourse
Use these documentation templates to ensure complete and accurate documentation for Painful Intercourse. These templates include all required elements for proper coding and billing.
Superficial dyspareunia
Specialty: GynecologyRequired Elements
- Pain location
- Pain characteristics
- Exacerbating factors
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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