2025 ICD-10-CM code N97.0
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the genitourinary system - Female infertility Diseases of the genitourinary system (N00-N99) Feed
Female infertility associated with anovulation.
The medical necessity for coding N97.0 rests on the clinical documentation confirming a diagnosis of female infertility directly attributed to anovulation. This requires a thorough evaluation ruling out other potential causes of infertility.Testing and diagnostic procedures mentioned under documentation requirements are necessary to establish medical necessity.
Obstetrician-Gynecologist (OB-GYN), Reproductive Endocrinologist, Fertility Specialist
In simple words: This code means a woman is unable to get pregnant because her body isn't releasing eggs from her ovaries regularly or at all. This is called anovulation.A normal menstrual cycle requires regular egg release for fertilization to occur.
This code signifies female infertility specifically related to the absence or irregularity of ovulation.Ovulation is the process where a mature egg is released from the ovary, a crucial step for conception.Anovulation, therefore, prevents pregnancy.This code includes instances of sterility in women where the cause is the lack of ovulation. It excludes infertility due to other causes such as issues with the cervix, uterus, tubes or other hormonal imbalances.
Example 1: A 32-year-old woman presents with primary infertility (never been pregnant) and irregular menstrual cycles.Testing reveals infrequent or absent ovulation. This scenario aligns with N97.0., A 38-year-old woman with a history of regular cycles experiences secondary infertility (previous pregnancy) after one year of trying to conceive.Ovulation testing confirms infrequent or absent ovulation as the primary cause., A 28-year-old woman is diagnosed with Polycystic Ovary Syndrome (PCOS), which frequently causes anovulation.She presents with symptoms like irregular menstruation and acne, and infertility workup confirms the diagnosis leading to the application of code N97.0.
Detailed history of menstrual cycles, including frequency, regularity, and duration.Results of ovulation prediction kits, ultrasound examinations to assess ovarian follicles and uterine lining thickness. Serum hormone levels (FSH, LH, estradiol, progesterone), and possibly other investigations depending on the individual situation (e.g., thyroid function testing, prolactin levels). Results of semen analysis if a partner is involved. Information about prior pregnancies, miscarriages, or other relevant medical history.
** This code is highly dependent on appropriate clinical investigation to support the diagnosis.Improper application may lead to inaccurate billing and potential reimbursement issues.
- Payment Status: Active
- Specialties:Obstetrics and Gynecology, Endocrinology, Reproductive Endocrinology and Infertility
- Place of Service:Office, Outpatient Clinic, Hospital