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ICD-10 Guide
ICD-10 CodesR87.1

R87.1

Abnormal level of hormones in specimens from female genital organs

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 R87.1 is a billable code used to indicate a diagnosis of abnormal level of hormones in specimens from female genital organs.

Key Diagnostic Point:

R87.1 refers to abnormal hormone levels detected in specimens obtained from female genital organs, which may include blood, urine, or tissue samples. Hormonal imbalances can manifest through various symptoms such as irregular menstrual cycles, infertility, and signs of hyperandrogenism (e.g., hirsutism, acne). The abnormal levels may indicate underlying conditions such as polycystic ovary syndrome (PCOS), adrenal disorders, or pituitary gland dysfunction. Accurate diagnosis often requires correlating laboratory findings with clinical symptoms and may involve additional testing to determine the specific type of hormone imbalance. Clinicians must consider the patient's age, medical history, and presenting symptoms to guide further evaluation and management. This code is essential for capturing the complexity of hormonal disorders in female patients and ensuring appropriate treatment pathways are followed.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of hormones that can be tested (e.g., estrogen, progesterone, testosterone)
  • Need for correlation with clinical symptoms for accurate diagnosis
  • Potential for multiple underlying conditions causing abnormal levels
  • Variability in normal hormone levels based on age and menstrual cycle phase

Audit Risk Factors

  • Inadequate documentation of laboratory results
  • Failure to link abnormal findings to specific symptoms
  • Misinterpretation of normal vs. abnormal hormone levels
  • Lack of comprehensive patient history

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed patient history, lab results, and clinical findings must be documented to support the diagnosis.

Common Clinical Scenarios

Patients presenting with menstrual irregularities, infertility, or signs of hormonal imbalance.

Billing Considerations

Consider the patient's age and reproductive status when interpreting hormone levels.

Emergency Medicine

Documentation Requirements

Acute care documentation must include immediate lab results and any interventions performed.

Common Clinical Scenarios

Acute presentations of hormonal crises, such as adrenal insufficiency or severe menstrual bleeding.

Billing Considerations

Rapid assessment and documentation of symptoms are critical in emergency settings.

Coding Guidelines

Inclusion Criteria

Use R87.1 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the code is used in conjunction with appropriate clinical documentation and laboratory findings
  • Ensure that the abnormal hormone levels are clearly linked to the patient's symptoms

Exclusion Criteria

Do NOT use R87.1 When
No specific exclusions found.

Related CPT Codes

84144CPT Code

Testosterone, total

Clinical Scenario

Used when evaluating for hyperandrogenism in females.

Documentation Requirements

Document the reason for testing and correlate with clinical findings.

Specialty Considerations

Endocrinology may require additional tests based on initial findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of hormonal disorders, improving the accuracy of diagnoses and treatment plans. R87.1 provides a clear framework for capturing abnormal hormone levels in female patients.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hormonal disorders, improving the accuracy of diagnoses and treatment plans. R87.1 provides a clear framework for capturing abnormal hormone levels in female patients.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of hormonal disorders, improving the accuracy of diagnoses and treatment plans. R87.1 provides a clear framework for capturing abnormal hormone levels in female patients.

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 symptoms should prompt testing for abnormal hormone levels?

Symptoms such as irregular menstrual cycles, infertility, hirsutism, and unexplained weight changes should prompt further evaluation for hormonal imbalances.