2025 ICD-10-CM code N80.511
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the genitourinary system - Noninflammatory disorders of the female genital tract Chapter 14: Diseases of the genitourinary system Feed
Superficial endometriosis of the rectum.
No modifiers are typically applied with ICD-10 codes.
Medical necessity for coding N80.511 is established by the presence of symptoms consistent with endometriosis and confirmed through appropriate diagnostic testing and/or surgical findings. The severity of symptoms, impact on quality of life, and the need for intervention should be clearly documented.
Diagnosis and management of endometriosis, including physical examination, imaging studies (e.g., ultrasound, MRI), and potential surgical intervention depending on the severity of the condition.Pain management and fertility counseling may also be part of the clinical responsibility.
- Chapter 14: Diseases of the genitourinary system
- N80-N98 (Noninflammatory disorders of female genital tract)
In simple words: This code describes a type of endometriosis where tissue similar to the uterine lining is found on the surface of the rectum. Endometriosis is a condition where this tissue grows outside the uterus, causing pain and other symptoms.
This ICD-10-CM code classifies superficial endometriosis affecting the rectum.Endometriosis is a condition where tissue similar to the lining of the uterus (endometrium) grows outside of the uterus.In this specific case, the endometrial-like tissue is present on the surface of the rectal wall.
Example 1: A 35-year-old female patient presents with complaints of rectal pain, especially during menstruation.A colonoscopy and pelvic exam reveal superficial endometriosis on the rectal surface. Code N80.511 is used., A 40-year-old female patient undergoes a laparoscopy for suspected endometriosis.During the procedure, superficial lesions consistent with endometriosis are found on the rectum. Code N80.511 is assigned., A 28-year-old female patient with a history of infertility undergoes a diagnostic laparoscopy, revealing superficial endometriosis impacting the rectum. Code N80.511 is applied in conjunction with codes for infertility and other endometriosis findings.
Complete medical history including symptoms (e.g., pelvic pain, dysmenorrhea, rectal pain, abnormal bleeding), physical examination findings, imaging reports (e.g., transvaginal ultrasound, MRI), operative reports (if applicable), and pathology reports confirming the diagnosis of endometriosis.Documentation should clearly state the location and depth of the endometrial implants.
** This code is used for superficial endometriosis of the rectum.Deep endometriosis of the rectum would require a different code (N80.512).Accurate documentation is crucial for appropriate code selection.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Specialties:Gynecology, Gastroenterology, Reproductive Endocrinology
- Place of Service:Office, Hospital (inpatient or outpatient), Ambulatory Surgical Center