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ICD-10 Guide
ICD-10 CodesE28.31

E28.31

Billable

Premature menopause

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 E28.31 is a billable code used to indicate a diagnosis of premature menopause.

Key Diagnostic Point:

Premature menopause, defined as menopause occurring before the age of 40, can result from various factors including genetic predisposition, autoimmune disorders, and endocrine gland dysfunction. The condition is characterized by the cessation of menstrual periods and a decline in estrogen production, leading to symptoms such as hot flashes, night sweats, mood changes, and vaginal dryness. Hormonal imbalances, particularly involving the ovaries, pituitary gland, and adrenal glands, play a significant role in the onset of premature menopause. Conditions such as Turner syndrome, autoimmune oophoritis, and certain genetic mutations can lead to ovarian failure, while disorders of the pituitary gland may disrupt the hormonal signals necessary for ovulation. Additionally, adrenal disorders can influence estrogen levels, further complicating the clinical picture. Accurate diagnosis often requires a thorough evaluation of hormone levels, including follicle-stimulating hormone (FSH) and estradiol, alongside a detailed patient history. Understanding the underlying causes is crucial for managing symptoms and addressing any associated health risks, such as osteoporosis and cardiovascular disease.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes (genetic, autoimmune, endocrine disorders)
  • Need for comprehensive hormonal evaluation
  • Potential overlap with other endocrine disorders
  • Variability in symptom presentation

Audit Risk Factors

  • Inadequate documentation of symptoms and age
  • Failure to specify underlying causes
  • Misclassification with other menopause-related codes
  • Lack of supporting lab results

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed hormonal assessment results, patient history, and any relevant imaging studies.

Common Clinical Scenarios

Evaluation of patients with unexplained amenorrhea, hormonal imbalances, or symptoms of menopause at a young age.

Billing Considerations

Endocrinologists must ensure comprehensive documentation of all hormonal tests and any associated conditions.

Gynecology

Documentation Requirements

Menstrual history, symptomatology, and any previous gynecological conditions.

Common Clinical Scenarios

Management of patients presenting with early menopause symptoms and counseling regarding fertility and hormone replacement therapy.

Billing Considerations

Gynecologists should document the patient's age at onset and any family history of premature menopause.

Coding Guidelines

Inclusion Criteria

Use E28.31 When
  • According to ICD
  • 10 guidelines, E28
  • 31 should be used when a patient presents with premature menopause, defined as cessation of menstruation before age 40, with appropriate documentation of symptoms and any underlying conditions

Exclusion Criteria

Do NOT use E28.31 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

83036CPT Code

Estradiol test

Clinical Scenario

Used to confirm low estrogen levels in patients suspected of premature menopause.

Documentation Requirements

Document the reason for testing and any relevant clinical findings.

Specialty Considerations

Endocrinologists should ensure that the test results are correlated with clinical symptoms.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of premature menopause, improving the ability to capture the nuances of the condition and its underlying causes, which aids in better patient management and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of premature menopause, improving the ability to capture the nuances of the condition and its underlying causes, which aids in better patient management and research.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of premature menopause, improving the ability to capture the nuances of the condition and its underlying causes, which aids in better patient management and research.

Resources

Clinical References

  • •
    Premature Menopause: A Guide for Patients

Coding & Billing References

  • •
    Premature Menopause: A Guide for Patients

Frequently Asked Questions

What is the age range for premature menopause?

Premature menopause is defined as menopause occurring before the age of 40. It can occur due to various factors, including genetic conditions, autoimmune diseases, and certain medical treatments.