ICD-10 Coding for Female Infertility(N97.0, N97.1, N97.2, N97.9)
Complete ICD-10-CM coding and documentation guide for Female Infertility. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Female Infertility
N97.0-N97.9Primary Range
Female infertility
This range includes all codes related to female infertility, covering specific causes such as anovulation, tubal and uterine factors, and unspecified infertility.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N97.0 | Female infertility associated with anovulation | Use when infertility is due to anovulation confirmed by hormonal tests. |
|
| N97.1 | Female infertility of tubal origin | Use when infertility is due to tubal factors confirmed by imaging. |
|
| N97.2 | Female infertility of uterine origin | Use when infertility is due to uterine factors confirmed by imaging. |
|
| N97.9 | Female infertility, unspecified | Use only when no specific etiology is determined after evaluation. |
|
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 female infertility
Essential facts and insights about Female Infertility
Primary ICD-10-CM Codes for infertility female
Decision Criteria
clinical Criteria
- Confirmed anovulation via hormonal tests
Applicable To
- Anovulation
- Polycystic ovary syndrome (PCOS)
Excludes
- Primary ovarian failure (E28.39)
Clinical Validation Requirements
- Progesterone levels <3 ng/mL
- Absent LH surge
Code-Specific Risks
- Misdiagnosis if ovulation is confirmed
- Incorrect use without hormonal evidence
Coding Notes
- Ensure hormonal tests confirm anovulation before coding.
N97.1 - Female infertility of tubal origin
Use when infertility is due to tubal factors confirmed by imaging.
Applicable To
- Tubal occlusion
- Tubal abnormality
Excludes
- Pelvic inflammatory disease (N70-N77)
Clinical Validation Requirements
- Hysterosalpingogram (HSG) showing tubal blockage
- Laparoscopy findings
Coding Notes
Document imaging results clearly to support coding.
N97.2 - Female infertility of uterine origin
Use when infertility is due to uterine factors confirmed by imaging.
Applicable To
- Uterine fibroids
- Asherman’s syndrome
Excludes
- Cervical incompetence (N88.3)
Clinical Validation Requirements
- Hysteroscopy or MRI confirming uterine anomaly
Coding Notes
Ensure uterine anomalies are documented with imaging.
N97.9 - Female infertility, unspecified
Use only when no specific etiology is determined after evaluation.
Clinical Validation Requirements
- Used when no specific cause is identified
Coding Notes
Avoid using unless absolutely necessary; seek specific causes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 Female Infertility to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N97.0.
Impact
Clinical: Leads to inappropriate treatment plans., Regulatory: Increases risk of audit and non-compliance., Financial: May result in claim denials or reduced reimbursement.
Mitigation Strategy
Ensure documentation specifies the cause of infertility., Use structured templates to capture all necessary details.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Increases risk of audit and non-compliance., Data Quality: Reduces accuracy of patient records and data analytics.
Mitigation Strategy
Identify and code the specific cause of infertility.
Impact
Frequent use of unspecified codes like N97.9 can trigger audits.
Mitigation Strategy
Always seek to identify and document specific causes of infertility.
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 Female Infertility, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Female Infertility
Use these documentation templates to ensure complete and accurate documentation for Female Infertility. These templates include all required elements for proper coding and billing.
Infertility Evaluation
Specialty: Obstetrics and GynecologyRequired Elements
- Menstrual history
- Diagnostic test results
- Imaging findings
- Previous treatments
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Female Infertility? Ask your questions below.