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ICD-10 Guide
ICD-10 CodesN92.5

N92.5

Billable

Other specified irregular menstruation

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

Code Description

ICD-10 N92.5 is a billable code used to indicate a diagnosis of other specified irregular menstruation.

Key Diagnostic Point:

Irregular menstruation encompasses a variety of menstrual disorders characterized by deviations from the normal menstrual cycle. This includes variations in cycle length, flow, and frequency. N92.5 specifically captures cases of irregular menstruation that do not fit into more defined categories such as amenorrhea or oligomenorrhea. Causes can range from hormonal imbalances, such as polycystic ovary syndrome (PCOS), to stress, lifestyle changes, or underlying health conditions. Irregular menstruation can significantly impact a woman's reproductive health and may be associated with complications in fertility. It is crucial for healthcare providers to conduct thorough evaluations to determine the underlying causes of irregular menstruation, which may involve hormonal assessments, imaging studies, and lifestyle evaluations. Treatment options vary based on the underlying cause and may include hormonal therapies, lifestyle modifications, or addressing any identified health issues. Accurate coding of N92.5 is essential for proper management and treatment of patients experiencing these symptoms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes requiring thorough documentation
  • Overlap with other menstrual disorders leading to potential misclassification
  • Need for detailed patient history to establish the context of irregularity
  • Variability in clinical presentation among patients

Audit Risk Factors

  • Insufficient documentation of the patient's menstrual history
  • Failure to specify the underlying cause of irregular menstruation
  • Inconsistent coding practices among providers
  • Lack of follow-up documentation to support ongoing treatment

Specialty Focus

Medical Specialties

Gynecology

Documentation Requirements

Detailed menstrual history, physical examination findings, and any diagnostic tests performed.

Common Clinical Scenarios

Patients presenting with irregular cycles, heavy bleeding, or associated symptoms like pain.

Billing Considerations

Consideration of hormonal assessments and imaging studies to rule out structural abnormalities.

Endocrinology

Documentation Requirements

Thorough evaluation of hormonal levels and metabolic factors influencing menstrual cycles.

Common Clinical Scenarios

Patients with suspected endocrine disorders such as PCOS or thyroid dysfunction.

Billing Considerations

Documentation of laboratory results and treatment plans for hormonal regulation.

Coding Guidelines

Inclusion Criteria

Use N92.5 When
  • According to ICD
  • 10 guidelines, N92
  • 5 should be used when the irregular menstruation does not fit into other specified categories
  • Documentation must support the diagnosis, including the patient's history and any relevant diagnostic tests

Exclusion Criteria

Do NOT use N92.5 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

58100CPT Code

Endometrial biopsy

Clinical Scenario

Used when evaluating abnormal uterine bleeding associated with irregular menstruation.

Documentation Requirements

Indication for biopsy, patient history, and results of prior evaluations.

Specialty Considerations

Gynecologists should ensure clear documentation of the rationale for 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 menstrual disorders, improving the ability to capture the nuances of irregular menstruation and its underlying causes, which aids in better patient management and treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of menstrual disorders, improving the ability to capture the nuances of irregular menstruation and its underlying causes, which aids in better patient management and treatment planning.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of menstrual disorders, improving the ability to capture the nuances of irregular menstruation and its underlying causes, which aids in better patient management and treatment planning.

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 be documented to support the use of N92.5?

Documentation should include a detailed menstrual history, any relevant diagnostic tests, and the clinical rationale for the diagnosis of irregular menstruation.