ICD-10 Coding for Male Infertility(N46.9, N46.0, Z31.81)
Complete ICD-10-CM coding and documentation guide for Male Infertility. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Male 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 |
|---|---|---|---|
| N46.9 | Unspecified male infertility | Use when no specific cause of male infertility is documented. |
|
| N46.0 | Azoospermia | Use when azoospermia is confirmed by laboratory tests. |
|
| Z31.81 | Encounter for female infertility due to male factor | Use for female encounters when male infertility is the cause. |
|
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 male infertility
Essential facts and insights about Male Infertility
Primary ICD-10-CM Codes for male infertility
Decision Criteria
documentation Criteria
- Lack of specific findings or tests results
Applicable To
- General male infertility
Excludes
- Female infertility (N97)
Clinical Validation Requirements
- Documentation of infertility without specific etiology
Code-Specific Risks
- May lead to denials if specificity is required by payer.
Coding Notes
- Ensure documentation supports the use of an unspecified code.
N46.0 - Azoospermia
Use when azoospermia is confirmed by laboratory tests.
Applicable To
- Complete absence of sperm in semen
Excludes
- Obstructive azoospermia (Q55.4)
Clinical Validation Requirements
- Two semen analyses showing 0 sperm/ejaculate
Coding Notes
Pair with causative codes when applicable.
Z31.81 - Encounter for female infertility due to male factor
Use for female encounters when male infertility is the cause.
Applicable To
- Female undergoing treatment due to male partner's infertility
Clinical Validation Requirements
- Documented male factor infertility affecting female treatment
Coding Notes
Ensure proper sequencing with male infertility codes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Congenital absence of vas deferens
Q55.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Male Infertility to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N46.9.
Impact
Clinical: Inaccurate representation of patient condition, Regulatory: Potential non-compliance with coding standards, Financial: Risk of claim denials or reduced reimbursement
Mitigation Strategy
Ensure detailed documentation of test results, Use specific codes when possible
Impact
Reimbursement: May lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on patient encounters.
Mitigation Strategy
Use Z31.81 for female encounters due to male infertility.
Impact
High risk of audit if unspecified codes are used without justification.
Mitigation Strategy
Ensure documentation supports the use of specific codes.
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 Male Infertility, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Male Infertility
Use these documentation templates to ensure complete and accurate documentation for Male Infertility. These templates include all required elements for proper coding and billing.
Male infertility evaluation
Specialty: UrologyRequired Elements
- Patient history
- Semen analysis results
- Physical examination findings
- Diagnosis and treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Male Infertility? Ask your questions below.