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ICD-10 Guide
ICD-10 CodesN97.9

N97.9

Billable

Female infertility, unspecified

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

Code Description

ICD-10 N97.9 is a billable code used to indicate a diagnosis of female infertility, unspecified.

Key Diagnostic Point:

Female infertility, unspecified (ICD-10 code N97.9) refers to the inability of a woman to conceive after one year of unprotected intercourse or the inability to carry a pregnancy to term. This condition can arise from various factors, including hormonal imbalances, anatomical abnormalities, age-related factors, and lifestyle choices. Menstrual disorders such as irregular cycles, amenorrhea, or oligomenorrhea can significantly impact fertility by disrupting ovulation. Menopausal disorders, including premature ovarian failure, can also lead to infertility by reducing the number of viable eggs. Complications of artificial fertilization, such as ovarian hyperstimulation syndrome (OHSS) or ectopic pregnancies, may further complicate the reproductive health of women seeking assisted reproductive technologies. The diagnosis of female infertility often requires a comprehensive evaluation, including hormonal assessments, imaging studies, and possibly laparoscopy to identify underlying causes. The unspecified nature of this code indicates that the specific etiology of infertility has not been determined, necessitating further investigation and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes for infertility
  • Need for comprehensive documentation of patient history and diagnostic tests
  • Differentiation from other related codes (e.g., menstrual disorders)
  • Potential for co-existing conditions that may affect coding

Audit Risk Factors

  • Insufficient documentation of infertility workup
  • Failure to specify the duration of infertility
  • Inadequate linkage between diagnosis and treatment
  • Misclassification of infertility type (primary vs. secondary)

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Thorough documentation of menstrual history, fertility evaluations, and any treatments attempted.

Common Clinical Scenarios

Patients presenting with irregular menstrual cycles, history of miscarriages, or unsuccessful attempts at conception.

Billing Considerations

Ensure that all diagnostic tests and treatments are documented to support the infertility diagnosis.

Reproductive Endocrinology

Documentation Requirements

Detailed records of hormonal assays, imaging studies, and any assisted reproductive technologies used.

Common Clinical Scenarios

Patients undergoing IVF or other fertility treatments, particularly those with complex medical histories.

Billing Considerations

Documentation must clearly outline the rationale for infertility diagnosis and any interventions performed.

Coding Guidelines

Inclusion Criteria

Use N97.9 When
  • According to ICD
  • 10 coding guidelines, N97
  • 9 should be used when the specific cause of infertility is not documented
  • Coders should ensure that all relevant clinical information is captured to support the diagnosis and that any related conditions are also coded appropriately

Exclusion Criteria

Do NOT use N97.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

58321CPT Code

Laparoscopy, surgical, with or without biopsy

Clinical Scenario

Used for diagnostic evaluation of infertility when anatomical issues are suspected.

Documentation Requirements

Document indications for the procedure and findings.

Specialty Considerations

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-related conditions, improving the ability to track and manage female infertility cases. N97.9 serves as a catch-all for unspecified cases, highlighting the need for thorough documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of infertility-related conditions, improving the ability to track and manage female infertility cases. N97.9 serves as a catch-all for unspecified cases, highlighting the need for thorough documentation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of infertility-related conditions, improving the ability to track and manage female infertility cases. N97.9 serves as a catch-all for unspecified cases, highlighting the need for thorough documentation.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What does N97.9 mean?

N97.9 is the ICD-10 code for female infertility that is unspecified, indicating that the specific cause of infertility has not been determined.