ICD-10 Coding for Oligomenorrhea(N91.5, N91.1)
Complete ICD-10-CM coding and documentation guide for Oligomenorrhea. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Oligomenorrhea
N91.0-N91.5Primary Range
Menstrual disorders, including oligomenorrhea
This range includes codes for primary and secondary oligomenorrhea, as well as unspecified cases.
Polycystic ovarian syndrome (PCOS)
PCOS is a common cause of secondary oligomenorrhea and should be coded when applicable.
Thyroid disorders
Thyroid disorders can cause menstrual irregularities, including oligomenorrhea.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N91.5 | Oligomenorrhea, unspecified | Use when the cause of oligomenorrhea is not specified or determined. |
|
| N91.1 | Secondary oligomenorrhea | Use when a secondary cause of oligomenorrhea is 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 oligomenorrhea
Essential facts and insights about Oligomenorrhea
Primary ICD-10-CM Codes for oligomenorrhea
Decision Criteria
clinical Criteria
- Menstrual cycles longer than 35 days without known cause.
documentation Criteria
- Lack of specific etiology in medical records.
Clinical Validation Requirements
- Menstrual cycles longer than 35 days
- Exclusion of pregnancy
Code-Specific Risks
- Risk of under-documentation if cause is known but not specified.
Coding Notes
- Ensure documentation specifies whether oligomenorrhea is primary or secondary when possible.
N91.1 - Secondary oligomenorrhea
Use when a secondary cause of oligomenorrhea is documented.
Applicable To
- Oligomenorrhea due to secondary causes
Excludes
- Primary oligomenorrhea (N91.0)
Clinical Validation Requirements
- Documentation of secondary cause such as PCOS or thyroid disorder
Coding Notes
Ensure secondary cause is clearly documented.
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 Oligomenorrhea to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N91.5.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Thorough patient history, Comprehensive lab testing
Impact
Reimbursement: May result in lower reimbursement if specificity is not provided., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of medical records.
Mitigation Strategy
Use specific codes like N91.0 or N91.1 when the cause is documented.
Impact
Frequent use of unspecified codes like N91.5 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 Oligomenorrhea, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Oligomenorrhea
Use these documentation templates to ensure complete and accurate documentation for Oligomenorrhea. These templates include all required elements for proper coding and billing.
Oligomenorrhea secondary to PCOS
Specialty: GynecologyRequired Elements
- Menstrual cycle length
- Duration of symptoms
- Secondary cause documentation
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Oligomenorrhea? Ask your questions below.