Reimbursement Advisor

Luteal phase defect may warrant 2nd code

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Q What is the diagnosis code for luteal phase defect?

A Use ICD-9-CM code 256.8 (other ovarian dysfunction) for this condition. The luteal phase refers to the span of time during the menstrual cycle between ovulation and onset of the next menses. Most women have a luteal phase of 10 to 14 days. If the luteal phase lasts less than 10 days or longer than 14 days, the patient may have a luteal phase defect.

You might also consider adding a second code to further clarify the reason for the visit. For instance, evaluation for this problem may be related to infertility or recurrent spontaneous abortions.

If the patient miscarries frequently, let the payer know that the visit was not related to infertility by adding the code V13.29 (personal history of other genital system and obstetric disorders) or 629.9 (habitual aborter without current pregnancy).

Ms. Witt, former program manager in the Department of Coding and Nomenclature at the American College of Obstetricians and Gynecologists, is an independent coding and documentation consultant. Reimbursement Adviser reflects the most commonly accepted interpretations of CPT-4 and ICD-9-CM coding. When in doubt on a coding or billing matter, check with your individual payer.

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