Excludes1 pair
N92.4 vs N95-
N92.4 and N95 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.
The official note, declared on N95
excessive bleeding in the premenopausal period (N92.4)
N92.4
Excessive bleeding in the premenopausal period
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N80-N98
Use when the record says
- Climacteric menorrhagia or metrorrhagia
- Menopausal menorrhagia or metrorrhagia
- Perimenopausal bleeding
- Perimenopausal menorrhagia or metrorrhagia
- Preclimacteric menorrhagia or metrorrhagia
- Premenopausal menorrhagia or metrorrhagia
Indexed under
- Preclimacteric bleeding (menorrhagia)
- Bleeding › excessive, associated with menopausal onset
- Bleeding › menopausal
- Bleeding › perimenopausal
- Bleeding › preclimacteric
N95
Menopausal and other perimenopausal disorders
Not billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N80-N98
Use when the record says
- Menopausal and other perimenopausal disorders due to naturally occurring (age-related) menopause and perimenopause
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027