2025 ICD-10-CM code N80
Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus.
Medical necessity for endometriosis treatment is established by the presence of symptoms interfering with the patient's quality of life and/or impacting fertility.The specific treatment approach (medical management, surgical intervention) must be justified based on the severity of symptoms, the extent of the disease, and the patient's reproductive goals.
Diagnosis and management of endometriosis typically fall under the purview of gynecologists.They perform pelvic exams, order imaging studies (like ultrasound or MRI), and may recommend medical or surgical treatment.Pain management specialists may be involved if pain is a significant symptom.
In simple words: Endometriosis is a problem where tissue that normally lines the inside of your uterus grows outside of it.This can cause pain, difficulty getting pregnant, and very heavy periods. The pain is usually in your lower belly, lower back, or pelvic area.
Endometriosis is a benign condition characterized by the presence of tissue resembling endometrial tissue in atypical locations within the abdomen. It can affect various organs, including the ovaries, fallopian tubes, the area behind the uterus, bowels, and bladder. In rare instances, it can also manifest in other parts of the body.
Example 1: A 32-year-old female presents with chronic pelvic pain and dysmenorrhea (painful periods). Imaging reveals endometrial implants on her ovaries. She is diagnosed with N80.1 (Endometriosis of ovary)., A 28-year-old female experiencing infertility undergoes a laparoscopy, which identifies endometrial tissue in the area behind her uterus (rectovaginal septum). This is coded as N80.9 (Endometriosis, unspecified)., A 40-year-old female reports cyclical pain with bowel movements.A colonoscopy reveals the presence of endometriosis on her bowel.This scenario is documented as N80.8 (Endometriosis of other sites).
Documentation for endometriosis should include a detailed history of the patient's symptoms (e.g., pelvic pain, dysmenorrhea, infertility, dyspareunia), physical examination findings, and results of imaging studies (e.g., ultrasound, MRI, laparoscopy findings) confirming the presence and location of endometrial implants.
- Specialties:Gynecology, Obstetrics and Gynecology, Reproductive Endocrinology, Pain Management
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center