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ICD-10 Guide
ICD-10 CodesN84.9

N84.9

Billable

Polyp of female genital tract, unspecified

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

Code Description

ICD-10 N84.9 is a billable code used to indicate a diagnosis of polyp of female genital tract, unspecified.

Key Diagnostic Point:

Polyp of the female genital tract refers to a benign growth that can occur in various parts of the female reproductive system, including the cervix, uterus, and vagina. These polyps are often asymptomatic but can lead to abnormal bleeding, discharge, or discomfort. The exact etiology of these polyps is not fully understood, but they are thought to be related to hormonal changes, particularly estrogen. In some cases, they may be associated with conditions such as endometriosis, where endometrial tissue grows outside the uterus, leading to inflammation and the formation of polyps. Female genital prolapse, characterized by the descent of pelvic organs, can also complicate the presentation of polyps, as the structural changes may influence their development. Additionally, fistulas, which are abnormal connections between organs, can occur in conjunction with polyps, particularly in cases of severe pelvic pathology. Ovarian disorders, such as polycystic ovary syndrome (PCOS), may also coexist with polyps, complicating the clinical picture. Accurate diagnosis often requires imaging studies and histological examination to rule out malignancy, especially in postmenopausal women.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for differential diagnosis to rule out malignancy
  • Potential association with other gynecological conditions
  • Documentation of size, location, and number of polyps

Audit Risk Factors

  • Insufficient documentation of polyp characteristics
  • Lack of follow-up notes or treatment plans
  • Inconsistent coding with clinical findings
  • Failure to document associated conditions

Specialty Focus

Medical Specialties

Gynecology

Documentation Requirements

Detailed descriptions of polyp characteristics, associated symptoms, and any imaging or biopsy results.

Common Clinical Scenarios

Routine gynecological exams revealing polyps, abnormal uterine bleeding, or postmenopausal bleeding.

Billing Considerations

Ensure that all relevant clinical findings are documented to support the diagnosis and any associated procedures.

Pathology

Documentation Requirements

Histopathological reports detailing the nature of the polyp and any signs of dysplasia or malignancy.

Common Clinical Scenarios

Biopsy of polyps during hysteroscopy or colposcopy.

Billing Considerations

Accurate coding based on histological findings is crucial for proper billing and treatment planning.

Coding Guidelines

Inclusion Criteria

Use N84.9 When
  • According to ICD
  • 10 guidelines, N84
  • 9 should be used when the specific type of polyp is not documented
  • Coders should ensure that the documentation supports the diagnosis and that any associated conditions are also coded appropriately

Exclusion Criteria

Do NOT use N84.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

58120CPT Code

Hysteroscopy, diagnostic

Clinical Scenario

Used when a polyp is suspected and requires visualization and possible biopsy.

Documentation Requirements

Document indications for the procedure, findings, and any interventions performed.

Specialty Considerations

Ensure that the procedure is linked to the diagnosis of a polyp.

57500CPT Code

Colposcopy of the cervix

Clinical Scenario

Performed when a cervical polyp is found during examination.

Documentation Requirements

Document the findings and any biopsies taken.

Specialty Considerations

Link the procedure to the diagnosis of a cervical polyp.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of polyps, improving the ability to capture the nuances of female genital tract conditions. N84.9 serves as a catch-all for unspecified cases, but coders are encouraged to seek specificity to enhance clinical understanding and billing accuracy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of polyps, improving the ability to capture the nuances of female genital tract conditions. N84.9 serves as a catch-all for unspecified cases, but coders are encouraged to seek specificity to enhance clinical understanding and billing accuracy.

Reimbursement & Billing Impact

billing accuracy.

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 is the significance of coding N84.9?

Coding N84.9 is significant as it captures cases of polyps in the female genital tract that are not otherwise specified. Accurate coding is essential for proper treatment planning and reimbursement.

When should I use N84.9 instead of a more specific code?

Use N84.9 when the documentation does not specify the type or location of the polyp, or when the polyp is still under evaluation.