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v1.0.0
ICD-10 Guide
DiagnosesEndometrial Hyperplasia

Endometrial Hyperplasia

ICD-10 Coding for Endometrial Hyperplasia(N85.00, N85.01, N85.02)

PRIMARY SPECIALTYGynecology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Endometrial Hyperplasia?
Essential facts and insights about Endometrial Hyperplasia

Key Clinical Considerations:

  • Irregular menstrual bleeding
  • Heavy menstrual periods (menorrhagia)
  • Postmenopausal bleeding
  • Key diagnostic tests include transvaginal ultrasound and endometrial biopsy
  • Physical exam may reveal an enlarged uterus or abnormal vaginal discharge

Clinical Information

Clinical Criteria & Documentation Requirements

  • Document patient's menstrual history and symptoms
  • Include results of imaging and biopsy findings
  • Use specific terms like 'simple hyperplasia' or 'complex hyperplasia' in documentation
  • Examples: 'Patient presents with menorrhagia and is diagnosed with simple endometrial hyperplasia based on biopsy findings.'

Coding Guidelines

Usage Guidelines & Examples

  • Usage guidelines: Use specific codes based on the type of hyperplasia diagnosed.
  • Common errors: Misclassifying simple hyperplasia as complex or vice versa.

Code Exclusions

Important Exclusions

  • Endometrial carcinoma
  • Other uterine conditions such as fibroids or polyps

Related ICD-10 Codes

Primary Codes
N85.0
Endometrial hyperplasia, unspecified
N85.1
Simple endometrial hyperplasia
N85.2
Complex endometrial hyperplasia
Ancillary Codes
Z79.810
Differential Codes
R93.89
R93.89
for imaging findings without biopsy confirmation.
N85.02
N85.02
if biopsy shows atypia.
N85.01
N85.01
if biopsy shows no atypia.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Gynecology

Specialty Applications

  • Women of reproductive age experiencing abnormal bleeding
  • Postmenopausal women with bleeding or other symptoms

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

Documentation requirements?

Document the type of hyperplasia, symptoms, and diagnostic tests performed.

Billing considerations?

Ensure accurate coding based on biopsy results and associated symptoms for proper reimbursement.