ICD-10 Coding for Irregular Bleeding(N92.1, N92.5)
Complete ICD-10-CM coding and documentation guide for Irregular Bleeding. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Irregular Bleeding
N92-N93Primary Range
Excessive, frequent, and irregular menstruation
This range includes codes for various types of abnormal uterine bleeding, including irregular cycles and excessive bleeding.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N92.1 | Excessive and frequent menstruation with irregular cycle | Use when there is documented excessive bleeding with irregular cycles and confirmed organic pathology. |
|
| N92.5 | Other specified irregular menstruation | Use when irregular bleeding does not fit specific patterns and lacks organic pathology. |
|
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 irregular bleeding
Essential facts and insights about Irregular Bleeding
Primary ICD-10-CM Codes for irregular bleeding
Decision Criteria
clinical Criteria
- Documented excessive bleeding with irregular cycles and organic pathology.
coding Criteria
- Avoid using if bleeding is regular or lacks organic cause.
Applicable To
- Menometrorrhagia
- Intermenstrual bleeding
Clinical Validation Requirements
- Cycle length variability ≥8 days
- Objective blood loss measures (e.g., soaking 1 pad hourly ×6hrs)
- Structural pathology documentation (e.g., fibroids)
Code-Specific Risks
- Misclassification if organic cause is not documented
- Incorrect use if bleeding is regular
Coding Notes
- Ensure documentation of organic pathology to support N92.1.
N92.5 - Other specified irregular menstruation
Use when irregular bleeding does not fit specific patterns and lacks organic pathology.
Applicable To
- Irregular cycles without specific pattern
Excludes
- Excessive bleeding with regular cycles (N92.0)
Clinical Validation Requirements
- Irregular bleeding patterns not fitting N92.1
- Absence of organic pathology
Coding Notes
Ensure documentation supports lack of specific pattern or organic cause.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Acute blood loss anemia
D62Differential 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 Irregular Bleeding to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N92.1.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Increases risk of audit and non-compliance., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Ensure imaging or lab results are documented., Link clinical findings to the appropriate code.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audit and non-compliance., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Review clinical documentation to ensure the most specific code is used.
Impact
Using unspecified codes when specific codes apply.
Mitigation Strategy
Regularly review coding guidelines and ensure documentation supports the most specific code.
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 Irregular Bleeding, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Irregular Bleeding
Use these documentation templates to ensure complete and accurate documentation for Irregular Bleeding. These templates include all required elements for proper coding and billing.
Irregular bleeding with organic pathology
Specialty: GynecologyRequired Elements
- Menstrual history
- Objective blood loss measures
- Imaging findings
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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