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ICD-10 Guide
DiagnosesHormone Replacement Therapy

Hormone Replacement Therapy

ICD-10 Coding for Hormone Replacement Therapy(Z79.890, F64.0)

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

Diagnosis Overview

What is Hormone Replacement Therapy?
Essential facts and insights about Hormone Replacement Therapy

Key Clinical Considerations:

  • Symptoms of menopause (hot flashes, night sweats, vaginal dryness)
  • Blood tests for hormone levels (estrogen, progesterone, testosterone)
  • Physical exam may reveal signs of hormonal imbalance (e.g., skin changes, weight gain)

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history of symptoms and previous treatments
  • Specific hormone levels measured and their results
  • Examples of treatment plans and follow-up assessments

Coding Guidelines

Usage Guidelines & Examples

  • Follow guidelines for appropriate use of hormone therapy codes.
  • Common errors include using outdated codes or failing to document symptoms.

Code Exclusions

Important Exclusions

  • Conditions such as breast cancer or estrogen-dependent tumors
  • Alternative codes for non-hormonal treatments

Related ICD-10 Codes

Primary Codes
E28.39
Other ovarian dysfunction
N95.1
Menopausal and perimenopausal disorders
Ancillary Codes
F64.0
E23.0
Z87.890
Differential Codes
Z79.899
Z79.899
for other long-term drug therapies not specified as hormone replacement.
F64.9
F64.9
when specific gender identity disorder is not documented.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Endocrinology

Specialty Applications

  • Women experiencing menopause or perimenopause
  • Endocrinology clinics, primary care settings

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 patient history, symptoms, hormone levels, and treatment plan.

Billing considerations?

Ensure correct ICD codes are used and document medical necessity for therapy.