ICD-10 Coding for Pelvic Pain in Female(R10.2, N94.89, G89.18)
Complete ICD-10-CM coding and documentation guide for Pelvic Pain in Female. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pelvic Pain in Female
R10-R19Primary Range
Symptoms and signs involving the digestive system and abdomen
Includes codes for abdominal and pelvic pain, which are relevant for unspecified pelvic pain.
Noninflammatory disorders of female genital tract
Includes codes for conditions like endometriosis and other specified disorders of female genital organs.
Pain, not elsewhere classified
Includes codes for chronic pain and postoperative pain, relevant for pain management.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R10.2 | Pelvic and perineal pain | Use when pelvic pain is present without a definitive diagnosis. |
|
| N94.89 | Other specified conditions associated with female genital organs and menstrual cycle | Use for pain associated with menstrual cycle or unspecified female genital organ pain. |
|
| G89.18 | Other acute postprocedural pain | Use for postoperative pelvic pain, especially after hysterectomy. |
|
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 pelvic pain in females
Essential facts and insights about Pelvic Pain in Female
Primary ICD-10-CM Codes for pelvic pain in female
Decision Criteria
clinical Criteria
- No definitive diagnosis for pelvic pain
Applicable To
- Pain localized to vulva, vagina, adnexa, or perineum without confirmed pathology
Excludes
- Pain due to confirmed gynecological conditions
Clinical Validation Requirements
- Exclusion of urinary or gastrointestinal causes
- Negative urinalysis and normal colonoscopy
Code-Specific Risks
- Risk of undercoding if a more specific diagnosis is available
Coding Notes
- Ensure exclusion of other causes before using R10.2.
N94.89 - Other specified conditions associated with female genital organs and menstrual cycle
Use for pain associated with menstrual cycle or unspecified female genital organ pain.
Applicable To
- Cyclic pain, dyspareunia
Excludes
- Pain due to confirmed gynecological conditions
Clinical Validation Requirements
- Pain correlates with menstrual cycle
- Normal imaging results
Coding Notes
Ensure pain is related to menstrual cycle or unspecified genital organ issues.
G89.18 - Other acute postprocedural pain
Use for postoperative pelvic pain, especially after hysterectomy.
Applicable To
- Postoperative pain following gynecological procedures
Excludes
- Chronic pain conditions
Clinical Validation Requirements
- Pain onset within 90 days of surgery
- Documented as 'postoperative'
Coding Notes
Ensure documentation specifies postoperative nature of pain.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other acute postprocedural pain
G89.18Differential 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 Pelvic Pain in Female to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R10.2.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials or reduced reimbursement.
Mitigation Strategy
Use detailed templates for documentation, Include all relevant clinical findings
Impact
Reimbursement: May lead to incorrect DRG assignment and reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Code N80.9 as primary for endometriosis.
Impact
Reimbursement: Potential denial due to lack of specificity., Compliance: Non-compliance with CMS guidelines., Data Quality: Inaccurate data affecting patient care.
Mitigation Strategy
Use N83.201 for right ovarian cyst, N83.202 for left.
Impact
Using non-specific codes when a specific diagnosis is available.
Mitigation Strategy
Regular training on code updates and specificity requirements.
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 Pelvic Pain in Female, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pelvic Pain in Female
Use these documentation templates to ensure complete and accurate documentation for Pelvic Pain in Female. These templates include all required elements for proper coding and billing.
Chronic pelvic pain with unknown etiology
Specialty: GynecologyRequired Elements
- Location of pain
- Character and timing
- Associated symptoms
- Diagnostic tests
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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