ICD-10 Coding for Premenopausal(N95.1, E28.8)
Complete ICD-10-CM coding and documentation guide for Premenopausal. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Premenopausal
N95-N95.9Primary Range
Menopausal and other perimenopausal disorders
This range includes codes for menopausal and perimenopausal disorders, which are relevant for documenting premenopausal symptoms when transitioning to menopause.
Ovarian dysfunction
This range includes codes for ovarian dysfunction, which may be relevant if hormonal testing indicates ovarian issues in premenopausal patients.
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 for documenting menopausal symptoms without abnormal bleeding. |
|
| E28.8 | Other ovarian dysfunction | Use when ovarian dysfunction is confirmed by hormonal tests. |
|
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 premenopausal
Essential facts and insights about Premenopausal
Primary ICD-10-CM Codes for premenopausal
Decision Criteria
clinical Criteria
- Presence of vasomotor symptoms and FSH >25 IU/L
coding Criteria
- Absence of abnormal bleeding
Applicable To
- Vasomotor symptoms
- Psychological symptoms
- Urogenital symptoms without abnormal bleeding
Excludes
- Premature menopause (E28.31)
Clinical Validation Requirements
- FSH >25 IU/L
- Cycle variability ≥7 days for ≥2 consecutive cycles
Code-Specific Risks
- Confusion with perimenopausal bleeding codes
Coding Notes
- Ensure documentation includes specific symptoms and hormone levels.
E28.8 - Other ovarian dysfunction
Use when ovarian dysfunction is confirmed by hormonal tests.
Applicable To
- Hormonal dysfunction
Excludes
- Premature ovarian failure (E28.31)
Clinical Validation Requirements
- FSH 25-40 IU/L
- AMH <0.5 ng/mL
Coding Notes
Document specific hormonal test results.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other ovarian dysfunction
E28.8Differential 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 Premenopausal to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N95.1.
Impact
Clinical: Inadequate symptom tracking, Regulatory: Non-compliance with documentation standards, Financial: Potential claim denials
Mitigation Strategy
Use specific symptom scales, Include quantitative hormone levels
Impact
Reimbursement: Incorrect reimbursement due to wrong code usage., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient data records.
Mitigation Strategy
Use E89.40 for surgical menopause.
Impact
Using N95.1 without proper documentation of symptoms and hormone levels.
Mitigation Strategy
Ensure all documentation includes specific symptom details and hormone test results.
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 Premenopausal, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Premenopausal
Use these documentation templates to ensure complete and accurate documentation for Premenopausal. These templates include all required elements for proper coding and billing.
Premenopausal symptom evaluation
Specialty: GynecologyRequired Elements
- Symptom severity scale
- FSH and AMH levels
- Cycle variability documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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