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v1.0.0
ICD-10 Guide
ICD-10 CodesN94.19

N94.19

Billable

Other specified dyspareunia

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

Code Description

ICD-10 N94.19 is a billable code used to indicate a diagnosis of other specified dyspareunia.

Key Diagnostic Point:

Dyspareunia refers to persistent or recurrent pain during sexual intercourse. The term 'other specified dyspareunia' encompasses various causes of this condition that do not fall under more specific categories. This can include pain related to menstrual disorders such as endometriosis, which can cause significant discomfort during intercourse due to pelvic pain. Menopausal disorders may also contribute, as hormonal changes can lead to vaginal dryness and atrophy, resulting in painful intercourse. Additionally, female infertility treatments, including artificial fertilization, may lead to dyspareunia due to hormonal fluctuations or physical changes in the reproductive system. Understanding the multifactorial nature of dyspareunia is crucial for accurate diagnosis and treatment, as it can significantly impact a woman's reproductive health and overall quality of life. Proper documentation of the underlying causes and associated conditions is essential for effective coding and management of this condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes that can lead to dyspareunia
  • Need for detailed patient history to identify specific factors
  • Potential overlap with other gynecological conditions
  • Variability in patient presentation and symptomatology

Audit Risk Factors

  • Inadequate documentation of the underlying cause
  • Failure to specify associated conditions
  • Misuse of related codes leading to incorrect coding
  • Lack of clarity in patient history regarding sexual health

Specialty Focus

Medical Specialties

Gynecology

Documentation Requirements

Detailed patient history, including sexual health, menstrual cycle, and any treatments received.

Common Clinical Scenarios

Patients presenting with pelvic pain, history of endometriosis, or those undergoing fertility treatments.

Billing Considerations

Consideration of psychological factors and the impact of hormonal treatments on sexual health.

Reproductive Endocrinology

Documentation Requirements

Comprehensive evaluation of hormonal levels and reproductive health history.

Common Clinical Scenarios

Patients experiencing pain during intercourse post-fertility treatments or hormonal therapies.

Billing Considerations

Need for interdisciplinary communication regarding treatment plans and patient management.

Coding Guidelines

Inclusion Criteria

Use N94.19 When
  • According to ICD
  • 10 guidelines, N94
  • 19 should be used when the dyspareunia is specified as 'other' and does not fit into the more defined categories
  • Documentation must support the diagnosis and any associated conditions

Exclusion Criteria

Do NOT use N94.19 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Office visit, established patient

Clinical Scenario

Used when a patient presents for evaluation of dyspareunia.

Documentation Requirements

Document the patient's history, examination findings, and treatment plan.

Specialty Considerations

Gynecologists should ensure comprehensive documentation of sexual health.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of dyspareunia, enabling better tracking of the condition and its underlying causes, which can improve treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of dyspareunia, enabling better tracking of the condition and its underlying causes, which can improve treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of dyspareunia, enabling better tracking of the condition and its underlying causes, which can improve treatment outcomes.

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 N94.19 and N94.0?

N94.19 is used for dyspareunia with unspecified causes, while N94.0 is specifically for dyspareunia due to psychological factors. Proper documentation is essential to determine the correct code.