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ICD-10 Guide
ICD-10 CodesE28.9

E28.9

Billable

Ovarian dysfunction, unspecified

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

Code Description

ICD-10 E28.9 is a billable code used to indicate a diagnosis of ovarian dysfunction, unspecified.

Key Diagnostic Point:

Ovarian dysfunction, unspecified, refers to a condition characterized by the disruption of normal ovarian function, which can lead to irregularities in the menstrual cycle, infertility, and hormonal imbalances. This condition may arise from various underlying factors, including parathyroid, pituitary, and adrenal disorders, which can affect the endocrine system's regulation of reproductive hormones. Hormonal imbalances, such as elevated levels of luteinizing hormone (LH) or follicle-stimulating hormone (FSH), can indicate ovarian dysfunction. The condition may also be associated with polycystic ovary syndrome (PCOS), premature ovarian failure, or other endocrine disorders. Diagnosis typically involves a thorough clinical evaluation, including a detailed medical history, physical examination, and laboratory tests to assess hormone levels. Treatment options may vary based on the underlying cause and can include lifestyle modifications, hormonal therapies, or assisted reproductive technologies. Accurate coding is essential for appropriate management and reimbursement, as it reflects the complexity of the patient's condition and the healthcare services provided.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes (e.g., endocrine disorders)
  • Need for comprehensive documentation of symptoms and history
  • Differentiation from other reproductive disorders
  • Potential for co-morbid conditions affecting treatment

Audit Risk Factors

  • Insufficient documentation of symptoms and clinical findings
  • Failure to specify underlying causes or related conditions
  • Inconsistent coding practices among providers
  • Lack of follow-up documentation for ongoing treatment

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed hormone level assessments, imaging studies, and patient history.

Common Clinical Scenarios

Patients presenting with irregular menstrual cycles, infertility, or signs of hormonal imbalance.

Billing Considerations

Endocrinologists must document the specific hormonal assays performed and their results to support the diagnosis.

Gynecology

Documentation Requirements

Comprehensive gynecological history, physical examination findings, and any relevant imaging or lab results.

Common Clinical Scenarios

Women experiencing amenorrhea, oligomenorrhea, or other menstrual irregularities.

Billing Considerations

Gynecologists should ensure that all relevant reproductive health factors are documented to support the diagnosis of ovarian dysfunction.

Coding Guidelines

Inclusion Criteria

Use E28.9 When
  • According to ICD
  • 10 guidelines, E28
  • 9 should be used when the specific cause of ovarian dysfunction is not documented
  • Coders should ensure that all relevant clinical information is captured to support the diagnosis and any associated treatments

Exclusion Criteria

Do NOT use E28.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

83001CPT Code

Hormone level testing

Clinical Scenario

Used when evaluating patients for ovarian dysfunction.

Documentation Requirements

Document specific hormone tests performed and their results.

Specialty Considerations

Endocrinologists should ensure comprehensive hormone panels are included.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more detailed coding of ovarian dysfunction, enabling better tracking of patient outcomes and treatment efficacy. E28.9 provides a broad category for unspecified cases, but coders must ensure that they capture all relevant clinical details.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding of ovarian dysfunction, enabling better tracking of patient outcomes and treatment efficacy. E28.9 provides a broad category for unspecified cases, but coders must ensure that they capture all relevant clinical details.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What should I document to support the use of E28.9?

Document the patient's symptoms, any relevant lab results, and the clinical rationale for the diagnosis of ovarian dysfunction. Ensure that any underlying conditions are also noted.