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v1.0.0
ICD-10 Guide
ICD-10 CodesN91.2

N91.2

Billable

Amenorrhea, unspecified

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

Code Description

ICD-10 N91.2 is a billable code used to indicate a diagnosis of amenorrhea, unspecified.

Key Diagnostic Point:

Amenorrhea is defined as the absence of menstruation, which can be classified as primary or secondary. Primary amenorrhea refers to the absence of menstruation by age 15 in the presence of normal secondary sexual characteristics or by age 13 in the absence of secondary sexual characteristics. Secondary amenorrhea is defined as the cessation of menstruation for three consecutive cycles or for six months in women who have previously menstruated. The causes of amenorrhea can be varied, including hormonal imbalances, structural abnormalities, stress, excessive exercise, and significant weight loss or gain. In some cases, amenorrhea may be a symptom of underlying conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or pituitary tumors. The unspecified designation of N91.2 indicates that the specific cause of amenorrhea has not been determined or documented, which can complicate diagnosis and treatment. Accurate coding is essential for appropriate management and treatment planning, particularly in the context of reproductive health and fertility considerations.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes
  • Need for thorough patient history and examination
  • Differentiation between primary and secondary amenorrhea
  • Potential overlap with other menstrual disorders

Audit Risk Factors

  • Insufficient documentation of the cause of amenorrhea
  • Failure to differentiate between primary and secondary amenorrhea
  • Inadequate patient history regarding menstrual cycles
  • Lack of supporting clinical findings

Specialty Focus

Medical Specialties

Gynecology

Documentation Requirements

Detailed menstrual history, physical examination findings, and any relevant laboratory results.

Common Clinical Scenarios

Evaluation of a patient presenting with missed periods, assessment of hormonal levels, and management of underlying conditions.

Billing Considerations

Consideration of reproductive health implications and potential fertility treatments.

Endocrinology

Documentation Requirements

Thorough assessment of hormonal profiles, including thyroid function tests and pituitary hormone levels.

Common Clinical Scenarios

Diagnosis and management of amenorrhea related to endocrine disorders such as hypothyroidism or hyperprolactinemia.

Billing Considerations

Integration of hormonal therapy and monitoring of treatment response.

Coding Guidelines

Inclusion Criteria

Use N91.2 When
  • According to ICD
  • 10 guidelines, N91
  • 2 should be used when the specific cause of amenorrhea is not documented
  • Coders should ensure that all relevant clinical information is captured to avoid the use of unspecified codes when more specific codes are available

Exclusion Criteria

Do NOT use N91.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

58100CPT Code

Endometrial biopsy

Clinical Scenario

Used when evaluating abnormal uterine bleeding or amenorrhea.

Documentation Requirements

Indication for the procedure and results of prior evaluations.

Specialty Considerations

Gynecologists should document the rationale for the biopsy clearly.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specificity in coding menstrual disorders, including amenorrhea. This has improved the ability to capture the complexity of these conditions and their management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specificity in coding menstrual disorders, including amenorrhea. This has improved the ability to capture the complexity of these conditions and their management.

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 is the difference between primary and secondary amenorrhea?

Primary amenorrhea is when a girl has not started menstruating by age 15 or by age 13 without secondary sexual characteristics. Secondary amenorrhea is when a woman who has previously menstruated stops having periods for three consecutive cycles or for six months.