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ICD-10 Guide
ICD-10 CodesN80.03

N80.03

Billable

Adenomyosis of the uterus

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

Code Description

ICD-10 N80.03 is a billable code used to indicate a diagnosis of adenomyosis of the uterus.

Key Diagnostic Point:

Adenomyosis is a condition characterized by the presence of endometrial tissue within the myometrium, the muscular layer of the uterus. This condition often leads to an enlarged uterus and can cause significant pelvic pain, heavy menstrual bleeding, and dysmenorrhea. The exact etiology of adenomyosis remains unclear, but it is believed to be associated with hormonal influences, particularly estrogen. Patients may present with symptoms similar to those of endometriosis, including chronic pelvic pain and abnormal uterine bleeding. Diagnosis is typically made through imaging studies such as ultrasound or MRI, which can reveal an enlarged uterus and the presence of myometrial cysts. Adenomyosis can coexist with other gynecological conditions, including endometriosis, fibroids, and polyps, complicating the clinical picture. Treatment options vary from hormonal therapies to surgical interventions, depending on the severity of symptoms and the patient's reproductive plans.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from endometriosis and other uterine disorders
  • Variability in symptom presentation among patients
  • Need for imaging studies for accurate diagnosis
  • Potential for co-occurring conditions like fibroids or polyps

Audit Risk Factors

  • Inadequate documentation of imaging studies
  • Failure to document co-existing conditions
  • Misdiagnosis due to symptom overlap with endometriosis
  • Lack of clarity in treatment plans and responses

Specialty Focus

Medical Specialties

Gynecology

Documentation Requirements

Detailed patient history, imaging results, and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with chronic pelvic pain, heavy menstrual bleeding, or enlarged uterus.

Billing Considerations

Consideration of patient’s reproductive goals when planning treatment.

Radiology

Documentation Requirements

Clear imaging reports indicating the presence of adenomyosis and any differential diagnoses.

Common Clinical Scenarios

Imaging studies performed for patients with suspected adenomyosis.

Billing Considerations

Radiologists should be aware of the imaging characteristics of adenomyosis to provide accurate reports.

Coding Guidelines

Inclusion Criteria

Use N80.03 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of symptoms, imaging results, and treatment plans
  • Adenomyosis should be coded only when confirmed by imaging or histological examination

Exclusion Criteria

Do NOT use N80.03 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

58150CPT Code

Total abdominal hysterectomy

Clinical Scenario

Performed for severe adenomyosis symptoms.

Documentation Requirements

Operative report detailing the diagnosis and procedure performed.

Specialty Considerations

Gynecologists should ensure clear documentation of the diagnosis and indications for surgery.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of adenomyosis, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of detailed documentation and imaging confirmation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of adenomyosis, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of detailed documentation and imaging confirmation.

Reimbursement & Billing Impact

reimbursement processes. It emphasizes the importance of detailed documentation and imaging confirmation.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What is adenomyosis?

Adenomyosis is a condition where endometrial tissue grows into the muscular wall of the uterus, leading to symptoms such as pelvic pain and heavy menstrual bleeding.

How is adenomyosis diagnosed?

Diagnosis is typically made through imaging studies like ultrasound or MRI, which can show an enlarged uterus and myometrial cysts.

What are the treatment options for adenomyosis?

Treatment options include hormonal therapies, pain management, and surgical interventions such as hysterectomy, depending on the severity of symptoms and patient preferences.