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ICD-10 Guide
ICD-10 CodesN97.8

N97.8

Billable

Female infertility of other origin

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

Code Description

ICD-10 N97.8 is a billable code used to indicate a diagnosis of female infertility of other origin.

Key Diagnostic Point:

Female infertility of other origin (N97.8) refers to cases of infertility in women that cannot be attributed to the more common causes such as ovulatory disorders, tubal factors, or uterine abnormalities. This category encompasses a variety of underlying issues that may affect a woman's ability to conceive, including hormonal imbalances, unexplained infertility, and certain medical conditions that do not fit neatly into established categories. Menstrual disorders, such as irregular cycles or amenorrhea, can significantly impact fertility by disrupting ovulation. Additionally, menopausal disorders may lead to premature ovarian failure, further complicating the ability to conceive. Complications arising from artificial fertilization techniques, such as in vitro fertilization (IVF), may also fall under this code if they lead to infertility without a clear cause. Understanding the multifactorial nature of female infertility is crucial for accurate diagnosis and treatment, as it often requires a comprehensive evaluation of reproductive health, including hormonal assessments, imaging studies, and possibly genetic testing. This code is essential for capturing the complexity of female infertility cases that do not have a straightforward diagnosis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes that may not be well-documented
  • Overlap with other infertility codes, requiring careful differentiation
  • Need for comprehensive patient history and diagnostic testing
  • Potential for misclassification with other reproductive health issues

Audit Risk Factors

  • Insufficient documentation of the underlying cause of infertility
  • Failure to provide comprehensive patient history
  • Inconsistent coding of related conditions
  • Lack of clarity in treatment plans and outcomes

Specialty Focus

Medical Specialties

Reproductive Endocrinology

Documentation Requirements

Detailed hormonal assessments, imaging results, and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with unexplained infertility, hormonal imbalances, or complications from assisted reproductive technologies.

Billing Considerations

Ensure that all diagnostic tests and their results are clearly documented to support the diagnosis.

Obstetrics and Gynecology

Documentation Requirements

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

Common Clinical Scenarios

Women with irregular menstrual cycles or those seeking fertility treatments.

Billing Considerations

Documentation should include any referrals to specialists and the rationale for treatment decisions.

Coding Guidelines

Inclusion Criteria

Use N97.8 When
  • According to ICD
  • 10 coding guidelines, N97
  • 8 should be used when the cause of infertility is not specified or when it falls outside the defined categories
  • Coders must ensure that the diagnosis is supported by appropriate clinical documentation and that any related conditions are also coded accurately

Exclusion Criteria

Do NOT use N97.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

58321CPT Code

Intrauterine insemination

Clinical Scenario

Used in conjunction with N97.8 when a patient is undergoing assisted reproductive technology.

Documentation Requirements

Document the indication for the procedure and any prior infertility treatments.

Specialty Considerations

Reproductive endocrinologists should ensure that all relevant patient history is included.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of infertility cases, including those of other origin. This specificity aids in better tracking of infertility trends and treatment outcomes, ultimately improving patient care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of infertility cases, including those of other origin. This specificity aids in better tracking of infertility trends and treatment outcomes, ultimately improving patient care.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)
  • •
    Society for Reproductive Endocrinology and Infertility (SREI)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)
  • •
    Society for Reproductive Endocrinology and Infertility (SREI)

Frequently Asked Questions

What should be documented to support the use of N97.8?

Documentation should include a thorough medical history, results of any diagnostic tests, and a clear treatment plan that outlines the rationale for the diagnosis of infertility of other origin.

How can I differentiate N97.8 from other infertility codes?

N97.8 should be used when the cause of infertility is not clearly defined or falls outside the established categories. Ensure that all relevant clinical information is documented to support this coding.