ICD-10 Coding for Irregular Menses(N92.6, N92.1)
Complete ICD-10-CM coding and documentation guide for Irregular Menses. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Irregular Menses
N92.0-N92.6Primary Range
Excessive, frequent and irregular menstruation
This range includes codes for various types of menstrual irregularities, including unspecified irregular menstruation, menorrhagia, and other specified irregularities.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N92.6 | Unspecified irregular menstruation | Use when menstrual irregularity is documented without specific details or underlying cause. |
|
| N92.1 | Menorrhagia | Use when heavy bleeding is documented alongside irregular cycles. |
|
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 menses
Essential facts and insights about Irregular Menses
Primary ICD-10-CM Codes for irregular menses
Decision Criteria
clinical Criteria
- Documented cycle length variability without specific cause
Applicable To
- Irregular menstrual cycles without further specification
Clinical Validation Requirements
- Cycle length variability ≥8 days
- Absence of identifiable structural pathology
Code-Specific Risks
- Risk of undercoding if specific details are available but not documented.
Coding Notes
- Ensure documentation specifies the nature of irregularity to avoid using unspecified codes.
N92.1 - Menorrhagia
Use when heavy bleeding is documented alongside irregular cycles.
Applicable To
- Heavy menstrual bleeding with irregular cycles
Excludes
- N92.0 (Excessive and frequent menstruation)
Clinical Validation Requirements
- Blood loss >80 mL
- Cycle variability ≥8 days
Coding Notes
Ensure heavy bleeding is documented with irregular cycles to justify use.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Polycystic ovarian syndrome
E28.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Irregular Menses to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N92.6.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Increases risk of audit and compliance issues., Financial: Potential for reduced reimbursement due to unspecified coding.
Mitigation Strategy
Train staff on importance of detailed menstrual documentation., Use templates to guide comprehensive history taking.
Impact
Reimbursement: May lead to lower reimbursement due to unspecified coding., Compliance: Increases risk of audit due to lack of specificity., Data Quality: Reduces data quality and accuracy in patient records.
Mitigation Strategy
Document specific cycle irregularities to use more specific codes.
Impact
Frequent use of unspecified codes can trigger audits.
Mitigation Strategy
Ensure documentation supports the most specific code possible.
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 Menses, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Irregular Menses
Use these documentation templates to ensure complete and accurate documentation for Irregular Menses. These templates include all required elements for proper coding and billing.
Irregular menstrual cycles
Specialty: GynecologyRequired Elements
- Cycle length
- Bleeding duration
- Associated symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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