Menopause ICD-10-CM codes

Menopausal symptoms such as hot flashes, night sweats, sleep disturbance and mood changes that the provider attributes to menopause are coded to N95.1 (menopausal and female climacteric states). Menopause with no symptoms, documented for example as a postmenopausal status during a wellness visit, is Z78.0 (asymptomatic menopausal state), which is in chapter 21, and N95.1 is not used. The two codes are mutually exclusive by Excludes1.

Other N95 codes address specific problems: N95.0 postmenopausal bleeding, which requires evaluation and is never bundled into N95.1; N95.2 postmenopausal atrophic vaginitis; N95.8 other specified menopausal disorders; N95.9 unspecified. Premature menopause (before age 40) is a chapter 4 code, E28.310 when symptomatic and E28.319 when asymptomatic. Surgical menopause after oophorectomy is E89.41 (symptomatic) or E89.40 (asymptomatic) with Z90.722 for acquired absence of ovaries; N95.1 is not assigned for postsurgical symptoms.

Patients on hormone replacement therapy carry Z79.890, and those on long-term SERMs or other non-hormonal therapy use Z79.899. Osteoporosis that develops after menopause is M81.0 and is reported separately. Perimenopausal heavy bleeding is N92.4 rather than an N95 code.