ICD-10 Coding for Premature Ovarian Failure(E28.3, E28.31, E28.39)
Complete ICD-10-CM coding and documentation guide for Premature Ovarian Failure. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Premature Ovarian Failure
E28.3-E28.39Primary Range
Disorders of ovarian function
This range includes codes for primary ovarian failure and its subtypes, which are directly related to premature ovarian failure.
Postprocedural ovarian failure
Used when ovarian failure is due to surgical or medical interventions, such as chemotherapy.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E28.3 | Primary ovarian failure | Use when ovarian failure is primary and not due to external interventions. |
|
| E28.31 | Premature menopause | Use for idiopathic premature menopause. |
|
| E28.39 | Other primary ovarian failure | Use when specific etiology like autoimmune or genetic is identified. |
|
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 premature ovarian failure
Essential facts and insights about Premature Ovarian Failure
Primary ICD-10-CM Codes for premature ovarian failure
Decision Criteria
clinical Criteria
- FSH levels and exclusion of iatrogenic causes
coding Criteria
- Avoid using with Turner syndrome
Applicable To
- Primary ovarian insufficiency
Clinical Validation Requirements
- FSH >25 IU/L on two occasions at least 4 weeks apart
- Exclusion of iatrogenic causes
Code-Specific Risks
- Confusion with postprocedural ovarian failure
- Incorrect use with Turner syndrome
Coding Notes
- Ensure documentation of FSH levels and exclusion of other causes.
E28.31 - Premature menopause
Use for idiopathic premature menopause.
Applicable To
- Natural cessation of menstruation before age 40
Excludes
- Ovarian failure due to other specified causes
Clinical Validation Requirements
- Cessation of menstruation before age 40 without known cause
Coding Notes
Document age of onset and absence of known causes.
E28.39 - Other primary ovarian failure
Use when specific etiology like autoimmune or genetic is identified.
Applicable To
- Ovarian failure due to autoimmune or genetic causes
Excludes
- Premature menopause (E28.31)
Clinical Validation Requirements
- FSH >25 IU/L with identified autoimmune or genetic cause
Coding Notes
Ensure documentation of specific etiology.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Personal history of ovarian failure
Z87.42Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Postprocedural ovarian failure
E89.4Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Premature Ovarian Failure to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E28.3.
Impact
Clinical: Misdiagnosis of primary ovarian failure., Regulatory: Non-compliance with ICD-10 guidelines., Financial: Potential claim denials.
Mitigation Strategy
Always verify and document the absence of surgical or medical interventions.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Use E89.4 for postprocedural ovarian failure.
Impact
Lack of documented FSH levels can lead to audit issues.
Mitigation Strategy
Ensure FSH levels are documented in all relevant cases.
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 Premature Ovarian Failure, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Premature Ovarian Failure
Use these documentation templates to ensure complete and accurate documentation for Premature Ovarian Failure. These templates include all required elements for proper coding and billing.
Diagnosis of Primary Ovarian Failure
Specialty: EndocrinologyRequired Elements
- Patient age
- FSH levels
- Exclusion of iatrogenic causes
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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