ICD-10 Code for Premature Menopause
The ICD-10 code for premature menopause (premature ovarian insufficiency) is E28.310 for symptomatic premature menopause.
Primary Diagnostic Codes
- E28.310 is used for symptomatic premature menopause, which includes women experiencing menopausal symptoms before age 40 1
- E28.319 is used for asymptomatic premature menopause or when symptom status is unspecified 2, 3
- The broader category E28.3 encompasses premature ovarian failure/insufficiency 4
Related Menopausal Codes
- N95.1 codes menopausal and female climacteric states (general menopause symptoms) 2, 3
- N95.2 codes postmenopausal atrophic vaginitis 2
- ICD-9 code 627 was previously used for menopause but has been replaced by the ICD-10 system 4
Clinical Context for Coding
Premature ovarian insufficiency (POI) is defined as menopause occurring before age 40, while early menopause occurs between ages 40-45. 1, 5 The distinction matters for coding accuracy:
- Women with amenorrhea for ≥4 months and two FSH measurements in the menopausal range (>40 mIU/ml) meet diagnostic criteria for POI 1
- Cancer survivors treated with alkylating agents or pelvic radiation have significantly elevated POI risk and should be coded appropriately 1, 4
- POI affects 1-3% of women and carries serious health consequences including increased cardiovascular disease risk (HR 1.61-1.69) and premature mortality 6, 1
Important Coding Considerations
Accurate ICD-10 coding for premature menopause is critically under-documented in clinical practice. A recent study found that among women with significant menopausal symptoms seeking care, only 23% had appropriate menopause-related ICD-10 codes documented 2. This coding gap has important implications:
- Women with documented codes were more likely to receive systemic hormone therapy (26% vs 9%) and vaginal hormone therapy (20% vs 6%) 2
- Proper coding is essential for tracking treatment patterns, quality metrics, and ensuring appropriate care 2, 3
- The lack of specific ICD codes for vasomotor symptoms creates challenges in accurately capturing VMS characteristics in claims data 3
Coding for Iatrogenic Premature Menopause
For cancer survivors with treatment-induced POI, document both the premature menopause code and the cancer history:
- Use E28.310 or E28.319 for the POI diagnosis 1, 4
- Include relevant cancer history codes, as POI risk varies by cancer type: breast cancer (aRR 4.32), leukemia (aRR 14.64), Hodgkin's lymphoma (aRR 2.37), and non-Hodgkin's lymphoma (aRR 3.77) 4
- Document treatment history including alkylating agents and radiation exposure, as these significantly increase POI risk 6, 1