N95.9 Unspecified menopausal and perimenopausal disorder

BillableNo payment HCCChapter 14

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Instructional notes

Chapter 14

Excludes2Not included here: the patient may have both; report both when both are present.

certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

N95

Excludes1Not coded here: never report with this code, except when the two conditions are unrelated.

excessive bleeding in the premenopausal period (N92.4)
menopausal and perimenopausal disorders due to artificial or premature menopause (E89.4-, E28.31-)
premature menopause (E28.31-)

Excludes2Not included here: the patient may have both; report both when both are present.

postmenopausal osteoporosis (M81.0-)
postmenopausal osteoporosis with current pathological fracture (M80.0-)
postmenopausal urethritis (N34.2)

Inclusion terms

Menopausal and other perimenopausal disorders due to naturally occurring (age-related) menopause and perimenopause

Chapter 14: Diseases of the genitourinary system · N80-N98 Noninflammatory disorders of female genital tract (N80-N98)

Source: ICD-10-CM FY 2027 code descriptions and tabular list (CMS and CDC National Center for Health Statistics), effective 2026-10-01 through 2027-09-30 · CMS ICD-10 files. HCC mapping: CMS-HCC V28, payment year 2027. As of 2026-11-04.

Coverage and payment depend on the claim details; confirm with the Medicare Administrative Contractor.