Is N94.3 a billable ICD-10-CM code?

Yes. N94.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does N94.3 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 N94.3?

N94.3 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

N94.3

N94.3 — Premenstrual tension syndrome

Billable / specific codeICD-10-CM

N94.3 is a billable, specific ICD-10-CM code for premenstrual tension syndrome. 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.

Premenstrual dysphoric disorder (F32.81)

Code also

Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.

associated menstrual migraine (G43.82-, G43.83-)

Other codes that can never be billed with N94.3

These codes carry an Excludes1 note pointing at N94.3. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading N94.3 alone.

F32.81Premenstrual dysphoric disorder

Risk adjustment

N94.3 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

N94.3 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.

A57130Billing and Coding: Psychiatric Codes

How N94.3 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 N94.3.

Molimen, molimina(menstrual)
Pain›premenstrual
Premenstrual›tension(syndrome)
Syndrome›premenstrual tension
Tension›premenstrual

Related codes at this level

Codes that share N94. If N94.3 is not quite right, the correct code is usually one of these.

Questions about N94.3

Is N94.3 a billable ICD-10-CM code?: Yes. N94.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does N94.3 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 N94.3?: N94.3 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.