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ICD-10 Guide
ICD-10 CodesN80.1

N80.1

Billable

Endometriosis of ovary

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

Code Description

ICD-10 N80.1 is a billable code used to indicate a diagnosis of endometriosis of ovary.

Key Diagnostic Point:

Endometriosis of the ovary is a condition characterized by the presence of endometrial-like tissue outside the uterus, specifically on the ovaries. This ectopic endometrial tissue can lead to inflammation, pain, and the formation of cysts known as endometriomas. Symptoms may include pelvic pain, dysmenorrhea, dyspareunia, and infertility. The condition can be diagnosed through pelvic examinations, imaging studies such as ultrasound or MRI, and sometimes laparoscopy, which allows for direct visualization and biopsy of the lesions. Endometriosis can significantly impact a woman's quality of life and may require a multidisciplinary approach for management, including pain relief, hormonal therapy, and surgical intervention. The severity of endometriosis can vary, and it is often classified based on the extent of lesions and adhesions found during surgical evaluation. Accurate coding is essential for appropriate treatment planning and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in symptom presentation and severity among patients
  • Need for precise documentation of location and extent of lesions
  • Differentiation from other ovarian disorders such as cysts or tumors
  • Potential for co-existing conditions like pelvic inflammatory disease

Audit Risk Factors

  • Inadequate documentation of symptoms and treatment plans
  • Failure to specify the location of endometriosis
  • Misclassification of endometriosis severity
  • Inconsistent coding of related procedures

Specialty Focus

Medical Specialties

Gynecology

Documentation Requirements

Detailed patient history, physical examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Diagnosis of endometriosis during routine gynecological exams, management of chronic pelvic pain, and surgical intervention for endometriomas.

Billing Considerations

Ensure that all findings from imaging and surgical procedures are documented to support the diagnosis.

Reproductive Endocrinology

Documentation Requirements

Comprehensive fertility evaluations, hormonal assessments, and treatment plans.

Common Clinical Scenarios

Evaluation of infertility in patients with known endometriosis and management of hormonal therapies.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use N80.1 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the diagnosis, including the specific site of endometriosis

Exclusion Criteria

Do NOT use N80.1 When
  • Exclude conditions that do not meet the criteria for endometriosis

Related ICD-10 Codes

Related CPT Codes

58661CPT Code

Laparoscopy, surgical, with ablation of endometriosis

Clinical Scenario

Used during surgical intervention for endometriosis of the ovary.

Documentation Requirements

Document the extent of endometriosis and the surgical approach taken.

Specialty Considerations

Ensure that the surgical findings are clearly documented to support the procedure.

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 diagnosis and treatment tracking. N80.1 provides a clear distinction for endometriosis of the ovary, facilitating better management and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of endometriosis, improving the accuracy of diagnosis and treatment tracking. N80.1 provides a clear distinction for endometriosis of the ovary, facilitating better management and reimbursement.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What are the common symptoms of endometriosis of the ovary?

Common symptoms include pelvic pain, painful periods, pain during intercourse, and infertility. Some women may also experience gastrointestinal symptoms.