ICD-10 Coding for Postmenopausal Symptoms(N95.0, N95.1, N95.2)
Complete ICD-10-CM coding and documentation guide for Postmenopausal Symptoms. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Postmenopausal Symptoms
N95.0-N95.9Primary Range
Menopausal and other perimenopausal disorders
This range includes codes for various symptoms and conditions associated with menopause, including bleeding, atrophic vaginitis, and general menopausal states.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N95.0 | Postmenopausal bleeding | Use when a patient presents with bleeding occurring 12 months or more after the last menstrual period. |
|
| N95.1 | Menopausal and female climacteric states | Use for general menopausal symptoms without specific complications. |
|
| N95.2 | Postmenopausal atrophic vaginitis | Use when vaginal dryness and dyspareunia are documented with lab confirmation. |
|
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 postmenopausal bleeding
Essential facts and insights about Postmenopausal Symptoms
Primary ICD-10-CM Codes for postmenopausal symptoms
Decision Criteria
clinical Criteria
- Bleeding after 12 months of amenorrhea with no malignancy.
Applicable To
- Bleeding after menopause
Excludes
- Endometrial cancer (C54.1)
Clinical Validation Requirements
- Endometrial biopsy results
- Pelvic ultrasound report
- Exclusion of malignancy
Code-Specific Risks
- Coding without histology confirmation when bleeding is recurrent
Coding Notes
- Ensure documentation includes endometrial assessment to support the use of N95.0.
N95.1 - Menopausal and female climacteric states
Use for general menopausal symptoms without specific complications.
Applicable To
- Vasomotor symptoms
Excludes
- Depression (F32.9)
Clinical Validation Requirements
- FSH >30 mIU/mL
- Documented vasomotor symptoms
Coding Notes
Ensure symptoms are clearly linked to menopause.
N95.2 - Postmenopausal atrophic vaginitis
Use when vaginal dryness and dyspareunia are documented with lab confirmation.
Applicable To
- Vaginal dryness
- Dyspareunia
Clinical Validation Requirements
- Vaginal pH test
- Maturation index showing >90% parabasal cells
Coding Notes
Pair with R34.1 if sexual pain is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Hormone replacement therapy (HRT)
Z79.890Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Postmenopausal Symptoms to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N95.0.
Impact
Clinical: May lead to incorrect treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Train staff on specific documentation practices., Use templates to ensure completeness.
Impact
Reimbursement: Unspecified codes may lead to denied claims., Compliance: Non-compliance with specificity requirements., Data Quality: Poor data quality due to lack of specificity.
Mitigation Strategy
Specify symptoms such as 'hot flashes' or 'vaginal dryness' and use appropriate codes.
Impact
High risk of audits for using N95.9 without specific symptoms.
Mitigation Strategy
Ensure all symptoms are documented with specificity.
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 Postmenopausal Symptoms, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Postmenopausal Symptoms
Use these documentation templates to ensure complete and accurate documentation for Postmenopausal Symptoms. These templates include all required elements for proper coding and billing.
Postmenopausal Bleeding
Specialty: GynecologyRequired Elements
- Patient history
- Symptom description
- Diagnostic test results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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