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ICD-10 Guide
ICD-10 CodesN80.0

N80.0

Billable

Endometriosis of uterus

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/18/2025

Code Description

ICD-10 N80.0 is a billable code used to indicate a diagnosis of endometriosis of uterus.

Key Diagnostic Point:

Endometriosis of the uterus is a chronic gynecological condition characterized by the presence of endometrial-like tissue outside the uterine cavity, primarily on the uterus itself. This ectopic endometrial tissue responds to hormonal changes during the menstrual cycle, leading to inflammation, pain, and the formation of adhesions. Symptoms may include dysmenorrhea (painful periods), chronic pelvic pain, dyspareunia (pain during intercourse), and infertility. Diagnosis is typically made through a combination of clinical evaluation, imaging studies such as ultrasound or MRI, and sometimes laparoscopy, which allows for direct visualization and biopsy of the lesions. The severity of endometriosis can vary significantly among individuals, and treatment options may include hormonal therapies, pain management, and surgical interventions to remove endometrial implants. Understanding the complexities of this condition is crucial for accurate coding and appropriate patient management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in symptom presentation among patients
  • Need for comprehensive documentation of clinical findings
  • Differentiation from other gynecological conditions
  • Potential for co-existing conditions such as ovarian cysts or fibroids

Audit Risk Factors

  • Inadequate documentation of symptoms and treatment
  • Failure to specify the location of endometriosis
  • Misclassification with other pelvic disorders
  • Lack of supporting imaging or surgical reports

Specialty Focus

Medical Specialties

Gynecology

Documentation Requirements

Detailed patient history, symptom description, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with chronic pelvic pain, infertility evaluations, and pre-operative assessments.

Billing Considerations

Ensure clear documentation of the extent of endometriosis and any surgical interventions performed.

Reproductive Endocrinology

Documentation Requirements

Comprehensive fertility assessments, hormonal evaluations, and treatment protocols.

Common Clinical Scenarios

Patients undergoing fertility treatments who have a history of endometriosis.

Billing Considerations

Document the impact of endometriosis on fertility and any assisted reproductive technologies used.

Coding Guidelines

Inclusion Criteria

Use N80.0 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the diagnosis, including the location and severity of endometriosis

Exclusion Criteria

Do NOT use N80.0 When
  • Exclude conditions that may mimic endometriosis symptoms

Related ICD-10 Codes

Related CPT Codes

58661CPT Code

Laparoscopy, surgical, with excision of endometriosis

Clinical Scenario

Used when surgical intervention is performed for endometriosis.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Ensure the procedure is linked to the diagnosis of endometriosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of endometriosis, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of the condition's prevalence and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of endometriosis, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of the condition's prevalence and treatment outcomes.

Reimbursement & Billing Impact

reimbursement processes. It has also facilitated better tracking of the condition's prevalence and treatment outcomes.

Resources

Clinical References

  • •
    Endometriosis Foundation of America

Coding & Billing References

  • •
    Endometriosis Foundation of America

Frequently Asked Questions

What are the common symptoms of endometriosis?

Common symptoms include pelvic pain, dysmenorrhea, dyspareunia, and infertility. Some women may also experience gastrointestinal symptoms.