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 CodesN97.1

N97.1

Billable

Female infertility of tubal origin

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

Code Description

ICD-10 N97.1 is a billable code used to indicate a diagnosis of female infertility of tubal origin.

Key Diagnostic Point:

Female infertility of tubal origin refers to the inability of a woman to conceive due to issues affecting the fallopian tubes. These tubes are crucial for the transport of eggs from the ovaries to the uterus and for the fertilization process. Conditions such as pelvic inflammatory disease (PID), endometriosis, or previous surgeries can lead to scarring or blockages in the tubes, preventing sperm from reaching the egg or the fertilized egg from reaching the uterus. Diagnosis typically involves a thorough medical history, physical examination, and imaging studies such as hysterosalpingography (HSG) to assess tubal patency. Treatment options may include surgical intervention to remove blockages or in vitro fertilization (IVF) if surgery is not feasible. Understanding the underlying causes of tubal infertility is essential for effective management and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various causes of infertility
  • Need for detailed documentation of prior medical history
  • Variability in diagnostic testing and results interpretation
  • Potential for co-existing conditions affecting fertility

Audit Risk Factors

  • Inadequate documentation of diagnostic tests
  • Failure to document prior treatments or surgeries
  • Misclassification of infertility type
  • Lack of clear linkage between diagnosis and treatment

Specialty Focus

Medical Specialties

Reproductive Endocrinology

Documentation Requirements

Detailed history of menstrual cycles, previous fertility treatments, and any surgical history.

Common Clinical Scenarios

Patients presenting with unexplained infertility, history of PID, or endometriosis.

Billing Considerations

Ensure all diagnostic tests and their results are documented to support the diagnosis.

Obstetrics and Gynecology

Documentation Requirements

Comprehensive gynecological history, including menstrual irregularities and previous pregnancies.

Common Clinical Scenarios

Routine infertility evaluations and management of patients with tubal factor infertility.

Billing Considerations

Document any referrals to specialists for advanced reproductive technologies.

Coding Guidelines

Inclusion Criteria

Use N97.1 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the cause of infertility
  • Include any relevant history and diagnostic tests performed

Exclusion Criteria

Do NOT use N97.1 When
  • Exclude conditions that do not directly relate to tubal factors

Related ICD-10 Codes

Related CPT Codes

58661CPT Code

Laparoscopy, surgical, with fulguration of oviducts

Clinical Scenario

Used when surgical intervention is performed to address tubal issues.

Documentation Requirements

Document the indication for surgery and findings during the procedure.

Specialty Considerations

Reproductive endocrinologists should ensure that all findings are clearly documented to support the coding.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of infertility types, improving the accuracy of data collection and reimbursement processes. N97.1 provides a clear indication of the tubal origin of infertility, which is essential for treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of infertility types, improving the accuracy of data collection and reimbursement processes. N97.1 provides a clear indication of the tubal origin of infertility, which is essential for treatment planning.

Reimbursement & Billing Impact

reimbursement processes. N97.1 provides a clear indication of the tubal origin of infertility, which is essential for treatment planning.

Resources

Clinical References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Coding & Billing References

  • •
    American College of Obstetricians and Gynecologists (ACOG)

Frequently Asked Questions

What are the common causes of female infertility of tubal origin?

Common causes include pelvic inflammatory disease, endometriosis, previous surgeries, and congenital abnormalities of the fallopian tubes.

How is tubal infertility diagnosed?

Diagnosis typically involves a combination of medical history, physical examination, and imaging studies such as hysterosalpingography (HSG) to assess the patency of the fallopian tubes.