ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesN95.1

N95.1

Billable

Menopausal and female climacteric states

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

Code Description

ICD-10 N95.1 is a billable code used to indicate a diagnosis of menopausal and female climacteric states.

Key Diagnostic Point:

N95.1 refers to menopausal and female climacteric states, which encompass a range of physiological and psychological changes that occur as women transition from reproductive to non-reproductive phases of life. This transition is marked by the cessation of menstruation, typically occurring between the ages of 45 and 55, and is characterized by a decline in estrogen and progesterone levels. Symptoms may include hot flashes, night sweats, mood swings, vaginal dryness, and sleep disturbances. These changes can lead to various menstrual disorders, such as irregular periods or amenorrhea, and may also contribute to female infertility. Additionally, complications arising from artificial fertilization procedures, such as ovarian hyperstimulation syndrome, may be relevant in this context. Understanding the nuances of menopausal and climacteric states is crucial for accurate diagnosis and treatment, as well as for appropriate coding and billing practices.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in symptom presentation among patients
  • Overlap with other reproductive health conditions
  • Need for comprehensive documentation of symptoms and treatments
  • Potential for co-morbidities affecting coding decisions

Audit Risk Factors

  • Inadequate documentation of menopausal symptoms
  • Failure to link symptoms to the diagnosis
  • Misuse of related codes leading to upcoding or downcoding
  • Lack of clarity in treatment plans

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed patient history, symptom description, treatment plans, and follow-up care.

Common Clinical Scenarios

Management of menopausal symptoms, treatment of menstrual irregularities, and counseling on reproductive health.

Billing Considerations

Ensure that all symptoms are documented clearly to support the diagnosis and any associated treatments.

Endocrinology

Documentation Requirements

Thorough hormonal assessments, lab results, and treatment protocols.

Common Clinical Scenarios

Evaluation of hormonal imbalances related to menopause and management of associated conditions.

Billing Considerations

Documenting lab results and treatment responses is critical for accurate coding.

Coding Guidelines

Inclusion Criteria

Use N95.1 When
  • According to ICD
  • 10 guidelines, N95
  • 1 should be used when a patient presents with specific menopausal symptoms that are documented in the medical record
  • It is important to differentiate between menopausal symptoms and other conditions that may mimic them

Exclusion Criteria

Do NOT use N95.1 When
  • Exclusion criteria include conditions that are not directly related to the menopausal transition

Related ICD-10 Codes

Related CPT Codes

58150CPT Code

Total abdominal hysterectomy

Clinical Scenario

When a patient undergoes surgery due to complications from menopausal symptoms.

Documentation Requirements

Surgical notes, pre-operative assessments, and post-operative care plans.

Specialty Considerations

Obstetricians should ensure that the reason for surgery is clearly linked to menopausal symptoms.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of menopausal and climacteric states, improving the accuracy of patient records and facilitating better management of women's health issues. This specificity aids in research and quality improvement initiatives.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of menopausal and climacteric states, improving the accuracy of patient records and facilitating better management of women's health issues. This specificity aids in research and quality improvement initiatives.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of menopausal and climacteric states, improving the accuracy of patient records and facilitating better management of women's health issues. This specificity aids in research and quality improvement initiatives.

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 symptoms are associated with N95.1?

Symptoms associated with N95.1 include hot flashes, night sweats, mood swings, vaginal dryness, and irregular menstrual cycles. Accurate documentation of these symptoms is essential for proper coding.