ICD Code N97.9

ICD code N97.9 is used to classify a condition where a female is experiencing infertility, but the specific cause or type of infertility has not been determined or specified. This code is utilized in medical records and billing to indicate that a woman is unable to conceive after a year of regular, unprotected intercourse, and the underlying reason for this infertility is not identified.

1. Inability to Conceive: Use the ICD code when a female patient has been unable to conceive after 12 months of regular, unprotected intercourse if under 35 years of age, or after 6 months if 35 years or older.

2. Irregular Menstrual Cycles: Document cases where the patient experiences irregular or absent menstrual cycles, which may indicate underlying issues affecting fertility.

3. History of Reproductive Health Issues: Apply the code when there is a documented history of reproductive health issues such as endometriosis, polycystic ovary syndrome (PCOS), or pelvic inflammatory disease (PID).

4. Previous Unsuccessful Fertility Treatments: Use the code if the patient has undergone previous fertility treatments, such as ovulation induction or assisted reproductive technologies, without success.

5. Hormonal Imbalances: Consider the code when there are signs of hormonal imbalances, such as abnormal levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), or thyroid hormones, which can impact fertility.

6. Anatomical Abnormalities: Apply the code in cases where diagnostic imaging or surgical findings reveal anatomical abnormalities in the reproductive organs, such as blocked fallopian tubes or uterine fibroids.

7. Unexplained Infertility: Use the code when all standard diagnostic tests have been conducted, and no specific cause for infertility has been identified, classifying the condition as unexplained infertility.

8. Age-Related Factors: Consider the code for patients experiencing age-related decline in fertility, particularly those over the age of 35, where age is a significant factor in infertility.

9. Lifestyle Factors: Document cases where lifestyle factors, such as obesity, smoking, or excessive alcohol consumption, are identified as contributing to infertility, and interventions have not resulted in conception.

10. Partner's Fertility Assessment: Ensure that the male partner's fertility has been assessed and ruled out as a contributing factor before applying the code for female infertility.

For the ICD code N97.9 (Female infertility, unspecified), the relevant CPT codes that may be applicable for treatment and diagnostic procedures include:

1. 58340 - Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography.

2. 58345 - Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency.

3. 58660 - Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure).

4. 58662 - Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method.

5. 58970 - Follicle puncture for oocyte retrieval, any method.

6. 58974 - Embryo transfer, intrauterine.

7. 76831 - Saline infusion sonohysterography (SIS), including color flow Doppler, when performed.

8. 89250 - Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryo(s).

These CPT codes are typically used in the context of diagnosing and treating female infertility, and healthcare providers should ensure accurate coding based on the specific services rendered. Always verify with the latest coding guidelines and payer policies.

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