Hot flashes ICD-10 code
The ICD-10-CM code for hot flashes is N95.1 (menopausal and female climacteric states). It is billable and valid for submission on a claim. There are 6 related codes, and which one you use depends on what the documentation supports.
Also written as hot flushes, flushing.
The mistake coders make here
N95.1 is menopausal. If the flushing is not menopausal, R23.2 is the symptom code. Do not default to N95.1 just because the patient is a woman of a certain age.
Putting hot flashes on a claim? Check the claim’s diagnosis codes free: Excludes1 conflicts, header codes and missing seventh characters, before it goes out.
ICD-10-CM codes for hot flashes
5 of 6 are billable. Green means you can submit it as-is.
Once you have the code
- Check the whole claim: Excludes1 conflicts and missing seventh characters, free
- Denial codes explained: what CO-16, CO-97 and the rest actually mean
- Decision guides: walk a chart note to a code, guideline cited
- Everything here that is free, and the one thing no free tool includes
Menopausal hot flashes are N95.1; everything else is R23.2
N95.1, menopausal and female climacteric states, is the code for hot flashes, night sweats and the other symptoms the provider attributes to natural menopause: the symptoms are included in it. R23.2, flushing, is the symptom code, and it applies whenever the hot flashes are not attributed to natural menopause: in a man, in a premenopausal woman, or when the provider documents hot flashes without naming the cause. N95.1 has an Excludes1 note for symptoms after artificial menopause and for the asymptomatic menopausal state, so it is never combined with those.
Surgical and drug-induced menopause are coded differently
Symptoms following surgical removal of the ovaries, or after radiation or chemotherapy has ended ovarian function, are E89.41, symptomatic states following artificially induced menopause, with an additional code for the symptom itself (R23.2 for the flushing). Hot flashes from tamoxifen, aromatase inhibitors or GnRH agonists are an adverse effect: code R23.2 with T45.1X5- (or the relevant drug's adverse-effect code) and the condition the drug is prescribed for. Z78.0 is the asymptomatic menopausal state and is not used when the patient has symptoms.
Common questions
- What is the ICD-10 code for hot flashes due to menopause?
- N95.1, menopausal and female climacteric states. The hot flashes are included in the code, so R23.2 is not added.
- What is the ICD-10 code for hot flashes in a man?
- R23.2, flushing. It is the symptom code for hot flashes of any cause other than natural menopause. If they are due to androgen-deprivation therapy, add the adverse-effect code for the drug.
- How do I code hot flashes after a hysterectomy with oophorectomy?
- E89.41, symptomatic states following artificially induced menopause, plus R23.2 for the flushing. N95.1 is for natural menopause only and has an Excludes1 note against E89.41.