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ICD-10 Guide
ICD-10 CodesChapter 14: Diseases of the genitourinary systemN94

N94

Billable

Pain and other conditions associated with female genital organs and menstrual cycle

Chapter 14:Diseases of the genitourinary system

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

Code Description

ICD-10 N94 is a billable code used to indicate a diagnosis of pain and other conditions associated with female genital organs and menstrual cycle.

Key Diagnostic Point:

The N94 code encompasses a range of conditions related to pain and other disorders affecting female genital organs and the menstrual cycle. This includes dysmenorrhea (painful menstruation), premenstrual syndrome (PMS), and other menstrual irregularities. It also covers menopausal symptoms such as hot flashes, mood changes, and vaginal dryness, which can significantly impact a woman's quality of life. Additionally, this code addresses issues related to female infertility, including anovulation and hormonal imbalances, as well as complications arising from artificial fertilization techniques. Accurate coding requires a thorough understanding of the patient's symptoms, history, and any relevant diagnostic findings, as these factors can influence treatment options and outcomes. The complexity of these conditions often necessitates a multidisciplinary approach, involving gynecologists, endocrinologists, and mental health professionals to provide comprehensive care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of symptoms and conditions under the code
  • Need for detailed patient history and documentation
  • Potential overlap with other ICD-10 codes
  • Variability in treatment approaches

Audit Risk Factors

  • Inadequate documentation of symptoms
  • Failure to specify the type of menstrual disorder
  • Misclassification of menopausal symptoms
  • Lack of supporting diagnostic tests

Specialty Focus

Medical Specialties

Gynecology

Documentation Requirements

Detailed patient history, symptom descriptions, and any diagnostic tests performed.

Common Clinical Scenarios

Patients presenting with dysmenorrhea, PMS, or menopausal symptoms.

Billing Considerations

Ensure that all relevant symptoms are documented to support the chosen code.

Reproductive Endocrinology

Documentation Requirements

Comprehensive hormonal assessments and fertility evaluations.

Common Clinical Scenarios

Patients undergoing evaluation for infertility or complications from artificial fertilization.

Billing Considerations

Document any hormonal treatments or interventions that may affect coding.

Coding Guidelines

Inclusion Criteria

Use N94 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the patient's condition
  • Include specific details about the type of pain, duration, and any associated symptoms

Exclusion Criteria

Do NOT use N94 When
  • Exclude conditions that are not directly related to the menstrual cycle or female genital organs

Related CPT Codes

58150CPT Code

Total abdominal hysterectomy

Clinical Scenario

Used in cases of severe dysmenorrhea unresponsive to conservative treatment.

Documentation Requirements

Document the patient's history, previous treatments, and rationale for surgery.

Specialty Considerations

Gynecologists should ensure all preoperative evaluations are complete.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions related to female reproductive health, improving the accuracy of diagnoses and treatment plans.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions related to female reproductive health, improving the accuracy of diagnoses and treatment plans.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions related to female reproductive health, improving the accuracy of diagnoses and treatment plans.

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 conditions are included under N94?

N94 includes various conditions such as dysmenorrhea, PMS, menopausal symptoms, and complications related to female infertility.