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v1.0.0
ICD-10 Guide
ICD-10 CodesN94.6

N94.6

Billable

Dysmenorrhea, unspecified

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

Code Description

ICD-10 N94.6 is a billable code used to indicate a diagnosis of dysmenorrhea, unspecified.

Key Diagnostic Point:

Dysmenorrhea refers to the pain associated with menstruation, which can manifest as cramping, throbbing, or aching in the lower abdomen. It may also be accompanied by symptoms such as nausea, vomiting, diarrhea, and headaches. Dysmenorrhea is classified into two types: primary and secondary. Primary dysmenorrhea is a common condition that occurs in the absence of any underlying pelvic pathology, typically beginning shortly after menarche and often improving with age or after childbirth. Secondary dysmenorrhea, on the other hand, is caused by underlying conditions such as endometriosis, fibroids, or pelvic inflammatory disease. The unspecified designation in N94.6 indicates that the specific type of dysmenorrhea has not been determined or documented. Accurate coding is essential for appropriate treatment and management of menstrual disorders, as well as for understanding the impact on reproductive health and female infertility. Dysmenorrhea can significantly affect a woman's quality of life, leading to missed work or school and necessitating effective management strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between primary and secondary dysmenorrhea
  • Need for comprehensive patient history to identify underlying causes
  • Variability in symptom presentation among patients
  • Potential overlap with other menstrual disorders

Audit Risk Factors

  • Insufficient documentation of symptoms
  • Failure to specify type of dysmenorrhea
  • Inadequate patient history regarding menstrual cycles
  • Misalignment between diagnosis and treatment provided

Specialty Focus

Medical Specialties

Gynecology

Documentation Requirements

Detailed patient history, including menstrual cycle patterns and associated symptoms.

Common Clinical Scenarios

Patients presenting with severe menstrual cramps, pelvic pain, or associated gastrointestinal symptoms.

Billing Considerations

Ensure documentation reflects the severity and impact of symptoms on daily activities.

Family Medicine

Documentation Requirements

Comprehensive review of menstrual history and any associated health issues.

Common Clinical Scenarios

Routine visits for menstrual pain management or evaluation of menstrual irregularities.

Billing Considerations

Consideration of lifestyle factors and their impact on menstrual health.

Coding Guidelines

Inclusion Criteria

Use N94.6 When
  • Follow official ICD
  • CM guidelines for coding menstrual disorders
  • 6 should be used when the type of dysmenorrhea is not specified
  • Ensure that documentation supports the diagnosis and reflects the patient's symptoms

Exclusion Criteria

Do NOT use N94.6 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 dysmenorrhea management.

Documentation Requirements

Document the patient's symptoms, treatment plan, and any changes in condition.

Specialty Considerations

Ensure that the visit reflects the complexity of the patient's condition.

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 conditions like dysmenorrhea. N94.6 provides a way to capture cases where the type of dysmenorrhea is not specified, but it is essential to ensure that documentation supports the diagnosis.

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 conditions like dysmenorrhea. N94.6 provides a way to capture cases where the type of dysmenorrhea is not specified, but it is essential to ensure that documentation supports the diagnosis.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of menstrual disorders, improving the ability to track and manage conditions like dysmenorrhea. N94.6 provides a way to capture cases where the type of dysmenorrhea is not specified, but it is essential to ensure that documentation supports the diagnosis.

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 difference between primary and secondary dysmenorrhea?

Primary dysmenorrhea is menstrual pain not associated with any underlying condition, while secondary dysmenorrhea is caused by identifiable conditions such as endometriosis or fibroids.