ICD Code N94.6

ICD code N94.6 is used to classify and code the diagnosis of dysmenorrhea, unspecified. Dysmenorrhea refers to the occurrence of painful menstrual cramps of uterine origin, and the term "unspecified" indicates that the specific type or cause of the dysmenorrhea has not been determined or documented. This code is utilized in medical billing and documentation to ensure accurate representation of the patient's condition when the exact nature of the menstrual pain is not clearly defined.

1. Pelvic Pain: Presence of recurrent or chronic pelvic pain that occurs specifically before or during menstruation.

2. Menstrual Irregularities: Observation of irregular menstrual cycles, including variations in cycle length or flow, that are accompanied by pain.

3. Absence of Identifiable Cause: After thorough evaluation, no specific underlying gynecological condition (such as endometriosis or fibroids) is identified as the cause of the menstrual pain.

4. Pain Severity: The pain experienced is significant enough to interfere with daily activities or requires medication for relief.

5. Onset Timing: The pain typically begins shortly before or at the onset of menstruation and may last for several days.

6. Associated Symptoms: May include nausea, vomiting, diarrhea, headache, or dizziness that coincide with the menstrual cycle.

7. Patient History: A detailed patient history that rules out other potential causes of pelvic pain, such as infections or structural abnormalities.

8. Physical Examination: A normal pelvic examination that does not reveal any abnormalities that could explain the pain.

9. Age of Onset: Often begins in adolescence or early adulthood, coinciding with the start of menstruation.

10. Response to Treatment: Pain may respond to non-steroidal anti-inflammatory drugs (NSAIDs) or hormonal contraceptives, which can help differentiate it from other conditions.

For the ICD code N94.6 (Dysmenorrhea, unspecified), the relevant CPT codes that may be applicable for treatment and management include:

1. 99201-99215 - Evaluation and Management (E/M) codes for office or other outpatient visits, depending on the complexity and time spent with the patient.

2. 58600 - Laparoscopy, surgical; with fulguration of oviducts (with or without transection), which may be used if surgical intervention is considered.

3. 58999 - Unlisted procedure, female genital system (nonobstetrical), which can be used for procedures not otherwise specified.

4. 97010-97799 - Physical Medicine and Rehabilitation codes, which may include physical therapy or other rehabilitative services that could be part of a comprehensive treatment plan.

5. 90832-90838 - Psychotherapy codes, if psychological support or therapy is part of the treatment plan.

6. A9270 - Non-covered item or service, which might be used for items or services that are not typically covered but are part of the treatment plan.

These CPT codes are examples and should be selected based on the specific services provided and the clinical judgment of the healthcare provider. Always ensure that coding is compliant with the latest guidelines and payer-specific requirements.

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