ICD-10 Coding for Galactorrhea(O92.6, N64.3)
Complete ICD-10-CM coding and documentation guide for Galactorrhea. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Galactorrhea
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| O92.6 | Postpartum galactorrhea | Use for galactorrhea occurring within the postpartum period. |
|
| N64.3 | Non-puerperal galactorrhea | Use for galactorrhea not associated with childbirth. |
|
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 postpartum galactorrhea
Essential facts and insights about Galactorrhea
Primary ICD-10-CM Codes for galactorrhea
Decision Criteria
clinical Criteria
- Patient is within 6 weeks postpartum
Applicable To
- Lactation not associated with breastfeeding
Excludes
- Non-puerperal galactorrhea (N64.3)
Clinical Validation Requirements
- Documentation of postpartum status
- Symptoms occurring within 6 weeks post-delivery
Code-Specific Risks
- Incorrect use if not postpartum
Coding Notes
- Ensure documentation specifies postpartum status.
N64.3 - Non-puerperal galactorrhea
Use for galactorrhea not associated with childbirth.
Applicable To
- Spontaneous milky discharge
Excludes
- Postpartum galactorrhea (O92.6)
Clinical Validation Requirements
- Prolactin level >20 ng/mL
- No recent pregnancy
Coding Notes
Ensure documentation of non-childbirth related context.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Galactorrhea to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O92.6.
Impact
Clinical: Misdiagnosis risk, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Always verify and document postpartum status, Use checklists for documentation
Impact
Reimbursement: Incorrect DRG assignment, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data
Mitigation Strategy
Use O92.6 for postpartum galactorrhea.
Impact
Risk of incorrect coding for postpartum galactorrhea
Mitigation Strategy
Implement regular training on postpartum documentation
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 Galactorrhea, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Galactorrhea
Use these documentation templates to ensure complete and accurate documentation for Galactorrhea. These templates include all required elements for proper coding and billing.
Non-puerperal galactorrhea in an endocrinology setting
Specialty: EndocrinologyRequired Elements
- Onset and duration
- Prolactin levels
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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