N85.7 — Hematometra
N85.7 is a billable, specific ICD-10-CM code for hematometra. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- hematometra with hematocolpos (N89.7)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Hematosalpinx with hematometra
Excludes1 inherited from the categories above N85.7
These are not written on N85.7, but they bind it: a note on a category applies to every code beneath it. Billing N85.7 with anything listed here is a denial.
Other codes that can never be billed with N85.7
These codes carry an Excludes1 note pointing at N85.7. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading N85.7 alone.
- N83.6Hematosalpinx
Risk adjustment
N85.7 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
N85.7 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56421Billing and Coding: CT of the Abdomen and Pelvis
How N85.7 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to N85.7.
- Hematometra
- Hemorrhage, hemorrhagic›intrauterine
- Hematosalpinx›with›hematometra
- Hemosalpinx›with›hematometra
Code history
N85.7 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share N85. If N85.7 is not quite right, the correct code is usually one of these.
Questions about N85.7
- Is N85.7 a billable ICD-10-CM code?
- Yes. N85.7 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does N85.7 sit in the tabular list?
- Diseases of the genitourinary system (N00-N99), in the block Noninflammatory disorders of female genital tract (N80-N98).
- What cannot be coded together with N85.7?
- N85.7 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above N85.7 (N85) and apply to it just the same.