ICD-10 Coding for Postmenopausal Syndrome(N95.1, N95.0, N95.2)
Complete ICD-10-CM coding and documentation guide for Postmenopausal Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Postmenopausal Syndrome
N95.0-N95.9Primary Range
Menopausal and other perimenopausal disorders
This range covers various menopausal disorders including postmenopausal bleeding, atrophic vaginitis, and general menopausal states.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N95.1 | Menopausal and female climacteric states | Use when documenting general menopausal symptoms without specific complications. |
|
| N95.0 | Postmenopausal bleeding | Use for bleeding in postmenopausal women without confirmed malignancy. |
|
| N95.2 | Postmenopausal atrophic vaginitis | Use when documenting urogenital atrophy symptoms in postmenopausal women. |
|
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 postmenopausal syndrome
Essential facts and insights about Postmenopausal Syndrome
Primary ICD-10-CM Codes for postmenopausal syndrome
Decision Criteria
clinical Criteria
- Presence of vasomotor symptoms and confirmed hormonal changes.
Applicable To
- Vasomotor symptoms
- Mood disorders
- Sleep disturbances
Excludes
- Premature menopause (E28.310)
Clinical Validation Requirements
- FSH >25 mIU/mL
- Amenorrhea for 12 months
Code-Specific Risks
- Lack of hormonal confirmation
Coding Notes
- Ensure symptoms are directly linked to menopausal state.
N95.0 - Postmenopausal bleeding
Use for bleeding in postmenopausal women without confirmed malignancy.
Applicable To
- Bleeding without confirmed pathology
Excludes
- Malignant neoplasm of endometrium (C54.1)
Clinical Validation Requirements
- Transvaginal ultrasound showing endometrial thickness <4mm
Coding Notes
Document temporal relationship if bleeding precedes cancer diagnosis.
N95.2 - Postmenopausal atrophic vaginitis
Use when documenting urogenital atrophy symptoms in postmenopausal women.
Applicable To
- Vaginal dryness
- Dyspareunia
Excludes
- Infective vaginitis (A59.0)
Clinical Validation Requirements
- Vaginal pH >4.5
- Vaginal epithelial atrophy
Coding Notes
Ensure pH and atrophy are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Depressive disorder, unspecified
F32.9Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Postmenopausal Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N95.1.
Impact
Clinical: Misdiagnosis risk., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Use specific symptom descriptions., Include lab results and clinical findings.
Impact
Reimbursement: Potential denial of claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure documentation of menopause status and pH testing.
Impact
Inadequate documentation of menopausal symptoms.
Mitigation Strategy
Use structured templates and ensure lab confirmations.
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 Postmenopausal Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Postmenopausal Syndrome
Use these documentation templates to ensure complete and accurate documentation for Postmenopausal Syndrome. These templates include all required elements for proper coding and billing.
General Menopausal Symptoms
Specialty: GynecologyRequired Elements
- Patient history
- Symptom log
- FSH/LH levels
- Physical exam findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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