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ICD-10 Guide
ICD-10 CodesN92.6

N92.6

Billable

Irregular menstruation, unspecified

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

Code Description

ICD-10 N92.6 is a billable code used to indicate a diagnosis of irregular menstruation, unspecified.

Key Diagnostic Point:

Irregular menstruation, unspecified, refers to menstrual cycles that do not follow a predictable pattern in terms of timing, duration, or flow. This condition can manifest as irregular intervals between periods, variations in the length of menstrual bleeding, or changes in the volume of menstrual flow. Irregular menstruation can be caused by a variety of factors, including hormonal imbalances, stress, significant weight changes, polycystic ovary syndrome (PCOS), thyroid disorders, and other underlying health issues. It is important to note that while irregular menstruation is common, especially during adolescence and perimenopause, it can also indicate more serious reproductive health concerns. Accurate diagnosis often requires a thorough medical history, physical examination, and possibly laboratory tests to identify any underlying conditions. Treatment options may vary based on the underlying cause and can include lifestyle modifications, hormonal therapies, or other medical interventions aimed at restoring regular menstrual cycles.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in patient presentation and underlying causes
  • Need for comprehensive documentation to support diagnosis
  • Potential overlap with other menstrual disorders
  • Influence of hormonal treatments and lifestyle factors

Audit Risk Factors

  • Insufficient documentation of menstrual history
  • Failure to specify underlying causes or contributing factors
  • Inconsistent coding practices among providers
  • Lack of follow-up documentation for ongoing treatment

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed menstrual history, physical examination findings, and any relevant lab results.

Common Clinical Scenarios

Patients presenting with irregular cycles, heavy bleeding, or associated symptoms like pain.

Billing Considerations

Consideration of hormonal therapies and their impact on menstrual regularity.

Endocrinology

Documentation Requirements

Thorough evaluation of hormonal levels and metabolic factors.

Common Clinical Scenarios

Patients with suspected hormonal imbalances affecting menstrual cycles.

Billing Considerations

Need for interdisciplinary collaboration with gynecologists for comprehensive care.

Coding Guidelines

Inclusion Criteria

Use N92.6 When
  • According to ICD
  • 10 guidelines, N92
  • 6 should be used when the irregularity of menstruation is documented but not specified further
  • Coders should ensure that the documentation supports the diagnosis and that no other more specific codes apply

Exclusion Criteria

Do NOT use N92.6 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits regarding irregular menstruation.

Documentation Requirements

Document the patient's menstrual history and any treatment changes.

Specialty Considerations

Ensure that the visit is linked to the diagnosis of irregular menstruation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of menstrual disorders, improving the ability to track and manage these conditions. N92.6 provides a broad category for irregular menstruation, which can help in identifying trends and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of menstrual disorders, improving the ability to track and manage these conditions. N92.6 provides a broad category for irregular menstruation, which can help in identifying trends and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of menstrual disorders, improving the ability to track and manage these conditions. N92.6 provides a broad category for irregular menstruation, which can help in identifying trends and treatment outcomes.

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 should I document to support the use of N92.6?

Document the patient's menstrual history, any associated symptoms, and any relevant medical history that may contribute to irregular menstruation. Ensure that the documentation is clear and supports the diagnosis.