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ICD-10 Guide
ICD-10 CodesN71.1

N71.1

Billable

Chronic inflammatory disease of uterus

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

Code Description

ICD-10 N71.1 is a billable code used to indicate a diagnosis of chronic inflammatory disease of uterus.

Key Diagnostic Point:

Chronic inflammatory disease of the uterus encompasses a range of gynecological conditions characterized by persistent inflammation of the uterine tissues. This condition can arise from various etiologies, including infections such as salpingitis (inflammation of the fallopian tubes), oophoritis (inflammation of the ovaries), and pelvic inflammatory disease (PID), which often involves the uterus, fallopian tubes, and surrounding structures. Endometritis, an inflammation of the endometrium, and cervicitis, inflammation of the cervix, are also common contributors to chronic uterine inflammation. Symptoms may include pelvic pain, abnormal vaginal discharge, and menstrual irregularities. Diagnosis typically involves a combination of clinical evaluation, imaging studies, and laboratory tests to identify underlying infections or inflammatory processes. Treatment often includes antibiotic therapy to address bacterial infections, along with potential gynecological procedures such as dilation and curettage (D&C) or hysteroscopy to remove any pathological tissue. Chronic inflammatory disease of the uterus can lead to complications such as infertility or chronic pelvic pain if left untreated.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes (infectious vs. non-infectious)
  • Overlap with other gynecological conditions
  • Need for comprehensive documentation of symptoms and treatments
  • Potential for multiple concurrent diagnoses

Audit Risk Factors

  • Inadequate documentation of chronicity
  • Failure to specify the underlying cause of inflammation
  • Misclassification of acute vs. chronic conditions
  • Lack of supporting documentation for antibiotic treatment

Specialty Focus

Medical Specialties

Gynecology

Documentation Requirements

Detailed patient history, including symptoms, diagnostic tests, and treatment plans.

Common Clinical Scenarios

Patients presenting with chronic pelvic pain, abnormal uterine bleeding, or recurrent infections.

Billing Considerations

Ensure clear documentation of the chronic nature of the condition and any associated procedures performed.

Infectious Disease

Documentation Requirements

Comprehensive records of laboratory results, treatment regimens, and response to therapy.

Common Clinical Scenarios

Patients with recurrent infections leading to chronic inflammation.

Billing Considerations

Document the specific pathogens involved and the rationale for antibiotic selection.

Coding Guidelines

Inclusion Criteria

Use N71.1 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the chronic nature of the condition
  • Include any relevant diagnostic tests and treatments

Exclusion Criteria

Do NOT use N71.1 When
  • Exclude conditions that do not meet the criteria for chronic inflammatory disease

Related ICD-10 Codes

Related CPT Codes

58120CPT Code

Dilation and curettage (D&C)

Clinical Scenario

Performed for chronic endometritis with N71.1 coded.

Documentation Requirements

Document indication for procedure and findings.

Specialty Considerations

Gynecologists should ensure clear linkage between diagnosis and procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of chronic conditions, improving the accuracy of data collection and reimbursement processes for chronic inflammatory diseases of the uterus.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of chronic conditions, improving the accuracy of data collection and reimbursement processes for chronic inflammatory diseases of the uterus.

Reimbursement & Billing Impact

reimbursement processes for chronic inflammatory diseases of the uterus.

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 are the common treatments for chronic inflammatory disease of the uterus?

Common treatments include antibiotic therapy for infections, hormonal treatments to manage symptoms, and surgical interventions such as D&C or hysteroscopy to address underlying issues.