ICD-10 Coding for Menstrual Irregularity(N92.6, N92.1)
Complete ICD-10-CM coding and documentation guide for Menstrual Irregularity. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Menstrual Irregularity
N92.0-N92.6Primary Range
Excessive, frequent and irregular menstruation
This range covers various types of menstrual irregularities, including excessive, frequent, and irregular menstruation.
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 | Irregular menstruation, unspecified | Use when menstrual irregularity is present but not further specified. |
|
| N92.1 | Excessive and frequent menstruation with irregular cycle | Use when both excessive bleeding and irregular cycles are documented. |
|
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 menstruation
Essential facts and insights about Menstrual Irregularity
Primary ICD-10-CM Codes for menstrual irregularity
Decision Criteria
clinical Criteria
- Irregular cycles documented over 3 months
coding Criteria
- No specific cause identified for irregularity
Clinical Validation Requirements
- Documentation of irregular cycles over a period of 3 months or more
- Exclusion of pregnancy through a negative hCG test
Code-Specific Risks
- Overuse of unspecified codes can lead to audits.
Coding Notes
- Ensure documentation specifies cycle irregularity and excludes other causes.
N92.1 - Excessive and frequent menstruation with irregular cycle
Use when both excessive bleeding and irregular cycles are documented.
Applicable To
- Menometrorrhagia
Excludes
- Irregular menstruation, unspecified (N92.6)
Clinical Validation Requirements
- Documentation of excessive bleeding and irregular cycle intervals
- Pictorial Blood Assessment Chart score ≥150
Coding Notes
Document both cycle irregularity and excessive bleeding for accurate coding.
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 Menstrual Irregularity 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 non-compliance with coding standards., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Use specific terms like 'menorrhagia' or 'metrorrhagia'., Document cycle length and flow details.
Impact
Reimbursement: May lead to reduced reimbursement rates., Compliance: Increases risk of audits., Data Quality: Affects the accuracy of health data.
Mitigation Strategy
Ensure documentation supports the most specific code available.
Impact
High frequency of unspecified codes can trigger audits.
Mitigation Strategy
Encourage detailed documentation to support specific coding.
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 Menstrual Irregularity, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Menstrual Irregularity
Use these documentation templates to ensure complete and accurate documentation for Menstrual Irregularity. These templates include all required elements for proper coding and billing.
Irregular Menstrual Cycles
Specialty: GynecologyRequired Elements
- Menstrual history
- Cycle length and variability
- Flow description
- Associated symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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