Perimenopause ICD-10-CM Codes | 2023

What ICD-10 Codes are Used for Perimenopause

ICD-10 (International Classification of Diseases, 10th Edition) codes categorize and document medical conditions and diagnoses. Perimenopause, the transitional phase leading to menopause, can be associated with various clinical conditions. 

Here are the commonly used Perimenopause ICD-10 codes, along with clinical descriptions for each code:

• N95.1 - Perimenopausal bleeding: This code documents abnormal uterine bleeding during the perimenopausal phase, characterized by irregular menstrual cycles.
• N95.0 - Postmenopausal bleeding: While this code technically refers to postmenopausal bleeding, it's essential to distinguish it from perimenopausal bleeding. Postmenopausal bleeding should be evaluated promptly, as it can be a sign of more severe conditions.
• E28.8 - Other ovarian dysfunction: Some perimenopausal women may experience ovarian dysfunction, which can lead to irregular cycles, hormonal imbalances, and various symptoms.
• E28.9 - Ovarian dysfunction, unspecified: This code is used when ovarian dysfunction is present during perimenopause, but the specific cause or nature is not well-defined.
• N94.6 - Dysmenorrhea, unspecified: Dysmenorrhea refers to painful menstruation, which can be experienced by women during the perimenopausal transition due to hormonal fluctuations.
• N94.3 - Premenstrual tension syndrome: Premenstrual tension syndrome (PMTS) is marked by emotional and physical symptoms that may worsen during perimenopause. This code is used when PMTS is diagnosed.
• N94.0 - Mittelschmerz: Mittelschmerz refers to pelvic pain midway through the menstrual cycle, often around ovulation. Some perimenopausal women may experience this discomfort.
• E34.8 - Other specified endocrine disorders: Perimenopause is associated with endocrine changes, and this code is used for less common endocrine disorders that may occur during this phase.
• F32.9 - Major depressive disorder, single episode, unspecified: Some women may experience depressive symptoms during perimenopause, and this code can be used to document major depressive disorder when the symptoms are severe.
• F41.9 - Anxiety disorder, unspecified: Perimenopausal women may also experience anxiety, which can be documented with this code when the specific anxiety disorder is not specified.

It's important to note that accurate coding and clinical documentation are essential for proper medical management and insurance billing. Healthcare providers should use the most specific codes based on the patient's clinical presentation to ensure the accurate representation of their condition during perimenopause.

Which Perimenopause ICD Codes are Billable

Whether specific ICD-10 codes related to perimenopause are billable can vary based on several factors, including the healthcare provider's documentation, the patient's insurance coverage, and the services provided. 

Here's a general indication of whether commonly used perimenopause-related ICD-10 codes are typically billable:

• N95.1 - Perimenopausal bleeding: Yes. 
• N95.0 - Postmenopausal bleeding: Yes.
• E28.8 - Other ovarian dysfunction: Yes.
• E28.9 - Ovarian dysfunction, unspecified: Yes.
• N94.6 - Dysmenorrhea, unspecified: Yes.
• N94.3 - Premenstrual tension syndrome: Yes.
• N94.0 - Mittelschmerz: Yes.
• E34.8 - Other specified endocrine disorders: Yes.
• F32.9 - Major depressive disorder, single episode, unspecified: Yes.
• F41.9 - Anxiety disorder, unspecified: Yes.

Accurate coding and documentation are crucial for successful billing. Clinicians should work closely with billing departments and understand patient insurance plan policies.

Clinical Information

• Perimenopause typically occurs in women between the ages of 40 and 55, although the exact timing can vary.
• Perimenopause is characterized by fluctuating hormone levels, primarily a decline in estrogen. These hormonal changes can lead to various symptoms.
• Irregular menstrual cycles are a common hallmark of perimenopause, with variations in flow, duration, and timing.
• Perimenopausal symptoms can include hot flashes, night sweats, mood swings, fatigue, vaginal dryness, and decreased libido.
• Estrogen decline during perimenopause can affect bone density, increasing the risk of osteoporosis.
• Changes in hormone levels can impact cardiovascular health. Healthcare providers should assess and manage heart health during this phase.
• Perimenopause is associated with an increased risk of mood disorders such as depression and anxiety.
• Treatment options for perimenopausal symptoms include hormone therapy, lifestyle changes, and psychotherapy for emotional well-being.
• Regular breast and cervical cancer screenings are essential during perimenopause.
• Healthcare providers should tailor their approach to each patient's unique symptoms and needs.
• Providing information and support to patients regarding the physical and emotional changes during perimenopause is crucial for their overall well-being.
• Regular follow-up appointments are essential to assess symptoms, monitor bone health, and adjust treatment plans as needed.
• Decision-making regarding treatment options should be a collaborative process between healthcare providers and patients, taking into account individual preferences and risks.

Synonyms Include

• Menopausal transition
• Climacteric phase
• Midlife transition
• Pre-menopause
• Menopause precursor
• Peri-menopausal period
• Peri-menopausal phase