Ob-Gyn Coding Alert

Don’t overlook these Excludes notes.

Vaginal bleeding other than a normal menstrual period or an abnormally heavy period can be cause for alarm. You’ll report abnormal uterine bleeding with 626.9 (Unspecified disorders of menstruation and other bleeding from female genital tract) if the provider has not specified the reason or given more specific information.

ICD-10-CM Change: When the ICD-10 implementation date rolls around, you will have two options for this abnormal uterine bleeding code. You will report either N92.6 (Irregular menstruation, unspecified) or N93.9 (Abnormal uterine and vaginal bleeding, unspecified) instead of 626.9.

Documentation: If your provider documents “irregular bleeding NOS” or “irregular periods NOS,” you should report N92.6.

Here is how you will locate these codes in your Alphabetic Index:

Bleeding —see also Hemorrhage

irregular N92.6

- uterus, uterine NEC N93.9

-- unrelated to menstrual cycle N93.9

- vagina, vaginal (abnormal) N93.9

Cycle

menstrual, irregular N92.6

Disorder (of) —see also Disease

- menstrual N92.6

Hemorrhage, hemorrhagic (concealed) R58

- uterus, uterine (abnormal) N93.9

- vagina (abnormal) N93.9

Irregular, irregularity

- bleeding N92.6

- menstruation (cause unknown) N92.6

- periods N92.6

Menstruation
cycle, irregular N92.6

- disorder N93.9

- irregular N92.6

Paramenia N92.6

Periods —see also Menstruation

- irregular N92.6

Upset

- menstruation N93.9

Coder tips: Underneath the N92 category (Excessive, frequent and irregular menstruation), you will see an Excludes1 note that forbids you from reporting any of these codes with postmenopausal bleeding (N95.0) or precocious puberty (menstruation) (E30.1).

Underneath N92.6, you have an Excludes1 note that forbids you from reporting this code with irregular menstruation with:

lengthened intervals or scanty bleeding (N91.3-N91.5)

shortened intervals or excessive bleeding (N92.1)

Underneath category N93 (Other abnormal uterine and vaginal bleeding), you will find an Excludes1 note forbidding you from reporting any of these codes with neonatal vaginal hemorrhage (P54.6), precocious puberty (menstruation) (E30.1), and pseudomenses (P54.6).