Ob-Gyn Coding Alert

Question: We have recently seen a number of patients with the diagnosis of premenstrual dysphonic disorder (PMDD). What is the correct ICD-9 code?

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Answer: PMDD is a severe form of premenstrual syndrome that has been under study for many years, but the etiology is not clearly established. Some researchers think it could be caused by an abnormal biochemical response to normal hormonal changes. In vulnerable women (about 3 to 8 percent of the female population of reproductive years in the United States by some estimates) the routine changes in estrogen and progesterone associated with the menstrual cycle induce a serotonin deficiency that can trigger the symptoms of PMDD, which include depression, anxiety, tension and irritability at least one week prior to the onset of menstruation. There is no specific code for this condition, and the closest code is 625.4 (premenstrual tension syndromes), which includes emotional instability.


Answers to You Be the Coder and Reader Questions provided by Melanie Witt, RN, CPC, MA, an ob/gyn coding expert and independent coding educator in Fredericksburg, Va.