ICD-10 Coding for Painful Period(N94.4, N94.5)
Complete ICD-10-CM coding and documentation guide for Painful Period. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Painful Period
N94.4-N94.5Primary Range
Dysmenorrhea, primary and secondary
These codes are used to classify painful periods, distinguishing between primary and secondary causes.
Pain, not elsewhere classified
These codes are used when the encounter is primarily for pain management related to dysmenorrhea.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N94.4 | Primary dysmenorrhea | Use when no underlying condition is identified causing the menstrual pain. |
|
| N94.5 | Secondary dysmenorrhea | Use when an underlying condition such as endometriosis is confirmed. |
|
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 painful periods
Essential facts and insights about Painful Period
Primary ICD-10-CM Codes for painful period
Decision Criteria
clinical Criteria
- Absence of identifiable pelvic pathology
documentation Criteria
- Detailed menstrual history and symptom description
Applicable To
- Cyclic pelvic pain without identifiable pathology
Excludes
- Secondary dysmenorrhea (N94.5)
Clinical Validation Requirements
- Normal pelvic exam and imaging
- Cyclic pain starting within 24 months post-menarche
Code-Specific Risks
- Misclassification if secondary causes are not ruled out
Coding Notes
- Ensure documentation specifies 'primary dysmenorrhea' to avoid unspecified coding.
N94.5 - Secondary dysmenorrhea
Use when an underlying condition such as endometriosis is confirmed.
Applicable To
- Menstrual pain due to endometriosis, fibroids
Excludes
- Primary dysmenorrhea (N94.4)
Clinical Validation Requirements
- Imaging or lab tests confirming underlying condition
- Chronic pelvic pain worsening during menses
Coding Notes
Document the specific underlying condition to ensure accurate coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Painful Period to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N94.4.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Increases risk of non-compliance during audits., Financial: Potential for claim denials or reduced reimbursement.
Mitigation Strategy
Ensure thorough documentation of diagnostic findings, Link dysmenorrhea to the underlying condition in notes
Impact
Reimbursement: May lead to reduced reimbursement or claim denial., Compliance: Increases risk of audit due to lack of specificity., Data Quality: Impacts data accuracy and quality for clinical research.
Mitigation Strategy
Query provider to specify primary or secondary dysmenorrhea.
Impact
High audit risk due to lack of specificity in coding.
Mitigation Strategy
Ensure documentation clearly differentiates between primary and secondary dysmenorrhea.
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 Painful Period, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Painful Period
Use these documentation templates to ensure complete and accurate documentation for Painful Period. These templates include all required elements for proper coding and billing.
Routine gynecological visit for dysmenorrhea
Specialty: GynecologyRequired Elements
- Menstrual history
- Pain characteristics
- Associated symptoms
- Diagnostic test results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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