Understanding Irregular Menses: Find information on diagnosis codes, clinical documentation tips, and healthcare resources for managing irregular periods. Learn about oligomenorrhea, amenorrhea, menorrhagia, metrorrhagia, and abnormal uterine bleeding. Explore medical coding guidelines for accurate billing and documentation best practices for improved patient care. This resource helps healthcare professionals and patients understand and address menstrual irregularities effectively.
Also known as
Other specified menstrual disorders
Covers various menstrual irregularities not classified elsewhere.
Unspecified menstrual disorder
Used when the specific menstrual irregularity is not documented.
Polycystic ovarian syndrome
PCOS can cause irregular menses due to hormonal imbalances.
Delayed puberty, female
May present with irregular menses or absent menstruation initially.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the patient pregnant?
Yes
Irregular menses associated with pregnancy is a normal physiological finding. Do not code. Document clinically.
No
Is there a known physiological cause (e.g., perimenopause, puberty)?
When to use each related code
| Description |
|---|
| Irregular periods |
| Oligomenorrhea |
| Bleeding between periods |
Coding N92.6 (Irregular menses NOS) without sufficient documentation specifying the type of irregularity (e.g., oligomenorrhea, polymenorrhea) leads to coding ambiguity and potential downcoding.
Failing to capture underlying causes like PCOS, thyroid disorders, or medications as secondary diagnoses impacts accurate risk adjustment and reimbursement.
Incorrectly coding irregular menses in perimenopause/menopause as N92.6 instead of appropriate menopausal codes can lead to clinical documentation integrity issues and claims denials.
Q: What are the most effective diagnostic strategies for evaluating irregular menses in adolescents, considering both primary and secondary amenorrhea?
A: Diagnosing irregular menses in adolescents requires a nuanced approach differentiating between primary and secondary amenorrhea. For primary amenorrhea (absence of menarche by age 15 with normal secondary sexual characteristics or by 13 without), investigations should include a thorough medical history, physical examination focusing on pubertal development and anatomical abnormalities, pelvic ultrasound to assess uterine and ovarian presence and morphology, and karyotyping to identify potential chromosomal abnormalities like Turner syndrome. For secondary amenorrhea (absence of menses for 3 cycles or 6 months in a previously menstruating female), initial evaluation includes pregnancy testing, thyroid function tests (TSH, free T4), prolactin levels, and potentially FSH and LH levels depending on clinical suspicion for premature ovarian insufficiency or polycystic ovary syndrome (PCOS). Further investigations such as a progestin challenge or MRI of the pituitary may be warranted if initial results are inconclusive. Consider implementing a step-wise diagnostic algorithm to ensure comprehensive and efficient evaluation. Explore how a standardized approach can improve diagnostic accuracy and patient outcomes in adolescent amenorrhea.
Q: How can I differentiate between physiological anovulation and pathological causes of irregular menses in young adult women presenting with oligomenorrhea or amenorrhea?
A: Distinguishing between physiological anovulation and pathological causes of oligomenorrhea or amenorrhea in young adult women necessitates a careful clinical assessment. Physiological anovulation, common in the first few years post-menarche and perimenopause, is often characterized by unpredictable menstrual cycles and can be related to fluctuations in the hypothalamic-pituitary-ovarian (HPO) axis. In contrast, pathological causes encompass a wider range of conditions, including PCOS, thyroid disorders (hypothyroidism and hyperthyroidism), hyperprolactinemia, premature ovarian insufficiency, and hypothalamic amenorrhea related to stress, weight loss, or excessive exercise. A comprehensive history focusing on menstrual patterns, weight changes, exercise habits, stress levels, and associated symptoms is crucial. Laboratory tests such as thyroid function tests, prolactin levels, FSH, LH, estradiol, and androgen levels help identify potential endocrine abnormalities. Pelvic ultrasound can assess ovarian morphology and endometrial thickness. Learn more about the specific diagnostic criteria for each condition to facilitate accurate diagnosis and guide appropriate management. Explore how integrating lifestyle factors into your assessment can differentiate functional hypothalamic amenorrhea from other pathological causes.
Patient presents with a chief complaint of irregular menses. Menstrual irregularity is characterized by variations in cycle length, frequency, and duration. The patient reports experiencing oligomenorrhea, defined as infrequent periods occurring greater than 35 days apart, and menorrhagia, excessively heavy menstrual bleeding lasting longer than seven days. The patient's menstrual cycle history reveals unpredictable bleeding patterns and inconsistent cycle lengths ranging from 20 to 45 days. Differential diagnoses considered include polycystic ovary syndrome (PCOS), hormonal imbalances, thyroid disorders, uterine fibroids, endometrial polyps, and other gynecological conditions. A comprehensive medical history, including menarche age, previous pregnancies, contraceptive use, and family history of menstrual disorders, was obtained. Physical examination, including pelvic examination, was performed. Laboratory testing, including a complete blood count (CBC), thyroid panel (TSH, Free T4), and hormonal profile (FSH, LH, prolactin, estradiol, progesterone) may be ordered to evaluate potential underlying causes. Pelvic ultrasound may be indicated to assess uterine and ovarian morphology. The patient's symptoms impact her quality of life, causing distress and anxiety. Initial management includes patient education regarding menstrual cycle variations and potential causes of irregular menses. Treatment options, including hormonal therapy, such as oral contraceptives or progestins, may be considered to regulate the menstrual cycle and manage heavy bleeding. Lifestyle modifications, including diet and exercise, may be recommended to improve overall health and potentially impact menstrual regularity. Follow-up appointments are scheduled to monitor treatment efficacy and assess symptom improvement. ICD-10 code N92.6 (Irregular menstruation) is documented for billing and coding purposes.