Ob-Gyn Coding Alert

One code expands into three more specific options in 2013

Dysmenorrhea refers to difficult and painful menstruation, but did you know there are two types? Primary dysmenorrhea occurs in the absence of pelvic pathology whereas the provider can identify an organic disease causing secondary dysmenorrhea.

Currently, you have 625.3 (Dysmenorrhea) as your only coding option. However, your options expand after October 1, 2013:

• N94.4, Primary dysmenorrhea
• N94.5, Secondary dysmenorrhea
• N94.6, Dysmenorrhea, unspecified

For ICD-10, you'll have to specify whether this condition is primary or secondary. You do have a third unspecified option, but payers are likely to prefer a more specific diagnosis.

Documentation: The provider needs to document whether the dysmenorrhea is primary or secondary. The provider might state "congestive dysmenorrhea," and that should direct you to N94.6.

Here's how you'll find this condition in the Alphabetic Index:

Dermatitis (eczematous) L30.9

-- dysmenorrheica N94.6

Dysmenorrhea (essential) (exfoliative) N94.6

-- congestive (syndrome) N94.6

-- primary N94.4

-- secondary N94.5

Mesiodens, mesiodentes K00.1

-- painful (see also Dysmenorrhea) N94.6

-- primary N94.4

-- psychogenic F45.8

-- secondary N94.5

Pain(s) (see also Painful) R52

-- menstrual (see also Dysmenorrhea) N94.6

Syndrome -- see also Disease

-- congestive dysmenorrhea N94.6

Coders tips: You'll see an Excludes1 note underneath N94.6 forbidding you from reporting this code with psychogenic dysmenorrhea (F45.8).