N95.1
N95.1: Menopausal and female climacteric states
Billable / specific codeICD-10-CM
N95.1 is a billable, specific ICD-10-CM code for menopausal and female climacteric states. It is valid for submission on a claim.
Check N95.1 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Use additional code
Add a secondary code to capture the detail described below.
- code for associated symptoms
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Symptoms such as flushing, sleeplessness, headache, lack of concentration, associated with natural (age-related) menopause
Excludes1 inherited from the categories above N95.1
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above N95.1
Not part of this code, but both may be coded when both are present.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
N95.1 is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52421Billing and Coding: Ibandronate Sodium
- A59040Billing and Coding: Bone Mass Measurement
Alphabetic index entries that lead here
- Climacteric›symptoms(female)
- Flushing›menopausal
- Hot flashes›menopausal
- Menopause, menopausal›symptomatic
- Sleeplessness›menopausal
- Symptoms NEC›menopausal
- Vertigo›menopausal
- State›climacteric, female›symptomatic
- State›menopausal›symptomatic
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.