N95.1 Menopausal and female climacteric states

Billable ICD-10-CM code, FY2026.

Applicable to

• Symptoms such as flushing, sleeplessness, headache, lack of concentration, associated with natural (age-related) menopause

Excludes1 (never code together)

• asymptomatic menopausal state (Z78.0)
• symptoms associated with artificial menopause (E89.41)
• symptoms associated with premature menopause (E28.310)

Use additional code

• code for associated symptoms

Applies from N95 Menopausal and other perimenopausal disorders

Applicable to

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

Excludes1 (never code together)

• 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-)

Excludes2 (not included here)

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

MS-DRG index

Defines the logic of DRG(s) 742-743 in MDC 13.

Approximate ICD-9-CM (GEMs)

• 627.2 Symptomatic menopausal or female climacteric states

Code annotations containing back-references to N95.1

Back-references to N95.1

• Code First: R23.2 Flushing (", if applicable, menopausal and female climacteric states (N95.1)")
• Code First: R61 Generalized hyperhidrosis (", if applicable, menopausal and female climacteric states (N95.1)")
• Type 2 Excludes: Z78.0 Asymptomatic menopausal state ("symptomatic menopausal state (N95.1)")

Diagnosis Index entries for N95.1

• Climacteric (female) › symptoms (female)
• Flushing › menopausal
• Hot flashes › menopausal
• Menopause, menopausal (asymptomatic) (state) › symptomatic
• Sleeplessness › menopausal
• State (of) › climacteric, female › symptomatic
• State (of) › menopausal › symptomatic
• Symptoms NEC › menopausal
• Vertigo › menopausal

Nearby codes

• N95 Menopausal and other perimenopausal disorders
• N95.0 Postmenopausal bleeding
• N95.1 Menopausal and female climacteric states (this code)
• N95.2 Postmenopausal atrophic vaginitis
• N95.8 Other specified menopausal and perimenopausal disorders
• N95.9 Unspecified menopausal and perimenopausal disorder