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ICD-10 Guide
ICD-10 CodesN97.2

N97.2

Billable

Female infertility of uterine origin

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

Code Description

ICD-10 N97.2 is a billable code used to indicate a diagnosis of female infertility of uterine origin.

Key Diagnostic Point:

Female infertility of uterine origin refers to the inability of a woman to conceive due to anatomical or functional abnormalities of the uterus. This condition can arise from various factors, including uterine fibroids, polyps, congenital anomalies, or scarring from previous surgeries or infections. The uterus plays a crucial role in implantation and maintaining a pregnancy, and any disruption in its structure or function can lead to infertility. Menstrual disorders, such as irregular cycles or heavy bleeding, may also be associated with uterine abnormalities, complicating the clinical picture. Additionally, menopausal disorders can impact fertility, as hormonal changes may affect uterine health. Understanding the underlying causes of uterine infertility is essential for developing effective treatment plans, which may include surgical interventions, hormonal therapies, or assisted reproductive technologies. Accurate diagnosis often requires imaging studies, such as hysterosalpingography or ultrasound, to assess uterine structure and function.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in underlying causes of uterine infertility
  • Need for detailed documentation of anatomical findings
  • Potential overlap with other infertility codes
  • Requirement for comprehensive patient history and diagnostic tests

Audit Risk Factors

  • Inadequate documentation of uterine abnormalities
  • Failure to specify the type of uterine condition
  • Misclassification of infertility origin
  • Lack of supporting diagnostic imaging reports

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed descriptions of uterine anatomy and any abnormalities found during examinations or imaging.

Common Clinical Scenarios

Patients presenting with infertility complaints, abnormal menstrual cycles, or previous uterine surgeries.

Billing Considerations

Ensure that all relevant diagnostic tests and imaging studies are documented to support the diagnosis.

Reproductive Endocrinology

Documentation Requirements

Comprehensive hormonal assessments and detailed fertility evaluations.

Common Clinical Scenarios

Patients undergoing assisted reproductive technologies or those with complex infertility cases.

Billing Considerations

Document all treatment plans and patient responses to therapies to justify coding.

Coding Guidelines

Inclusion Criteria

Use N97.2 When
  • According to ICD
  • 10 coding guidelines, N97
  • 2 should be used when infertility is specifically attributed to uterine factors
  • Coders must ensure that the diagnosis is supported by clinical documentation and diagnostic imaging results

Exclusion Criteria

Do NOT use N97.2 When
  • Exclusion criteria include infertility due to ovarian or tubal factors

Related ICD-10 Codes

Related CPT Codes

58340CPT Code

Hysteroscopy, diagnostic

Clinical Scenario

Used to evaluate uterine abnormalities in patients with infertility.

Documentation Requirements

Document findings from the hysteroscopy and any interventions performed.

Specialty Considerations

Obstetricians and gynecologists should ensure that the procedure is linked to the infertility diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of infertility causes, improving the accuracy of data collection and reimbursement processes. N97.2 provides a clear distinction for uterine-related infertility, which was less defined in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of infertility causes, improving the accuracy of data collection and reimbursement processes. N97.2 provides a clear distinction for uterine-related infertility, which was less defined in ICD-9.

Reimbursement & Billing Impact

reimbursement processes. N97.2 provides a clear distinction for uterine-related infertility, which was less defined in ICD-9.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What are the common causes of female infertility of uterine origin?

Common causes include uterine fibroids, polyps, congenital anomalies, and scarring from previous surgeries or infections. Each of these conditions can disrupt normal uterine function and implantation.