PMDD ICD 10 Code

Refresher: What are ICD-10 codes?

The International Classification of Diseases, 10th revision, is a list of medical conditions organized by the World Health Organization [1]. The ICD-10-CM is a clinically modified version of the ICD-10 authorized by the WHO for use in US healthcare organizations [2]. Its aim is to provide a common language to healthcare professionals and coders for recording, tracking, monitoring, and reporting disease.

The ICD-10 has over 68,000 codes compared to some 13,000 codes in the ICD-9 [3]. This allows healthcare professionals to capture more details about medical conditions with the aim of improving the patient's outcomes and quality of life.

The ICD-10 coding structure requires the first character to be an alpha character (excluding the u). The second and third characters are numeric, and the remaining characters (four through seven) may be alphanumeric.

Below is an example of the range of ICD-10-CM codes and the medical conditions that they cover:

A00 through B99 are used for infectious and parasitic disease
C00 through D49 are used for neoplasms
D50 through D89 are used for diseases of the blood and disorders involving the immune mechanisms,
F01 through F99 are applicable to mental, behavioral, and neurodevelopmental disorders
G00 through G99 are used for diseases of the nervous system

There’s also the ICD-10-PCS, a classification system used for classifying and tracking procedures performed in hospital inpatient settings. It has over 87,000 codes [4].

What is the ICD 10 code for PMDD?

For premenstrual dysphoric disorder, the general ICD-10 code is F32.81 (PMDD). The disorder causes a wide range of emotional and physical problems, including depression, irritability, and tension, among others. The code does not apply to premenstrual tension syndrome (N94.3), which may have similar symptoms and, thus, easily confused with premenstrual dysphoric disorder.

Premenstrual dysphoric disorder ICD 10 code: F32.81

Premenstrual dysphoric disorder ICD code F32.81 lookup

Premenstrual dysphoric disorder (PMDD) has an ICD 10 code of F32.81. There is no other code for PMDD.

It is estimated that at least 1 in 12 women in the US will experience PMDD [5]. Any patients who menstruate are at risk of the disorder. Data shows that 6 million, or about 1 in 20 women worldwide, will struggle with the condition [6].

The primary cause of PMDD is not known, although research suggests that genetics may be the most common risk factor. PMDD may also be an abnormal reaction to hormonal changes that take place during each menstrual cycle. These hormonal changes can cause a serotonin deficiency. Serotonin is a substrate that can change one’s mood and lead to various physical symptoms. PMDD does not impact women who do not menstruate.

PMDD occurs during the luteal phase of the menstrual cycle. The luteal phase lasts for about 2 weeks but may be longer or shorter in some people. During this time, women may experience the symptoms of PMDD every day or for a few days.

The symptoms of PMDD are different for each person, and patients may experience feelings that may not be below:

Mood swings
Feeling upset
Lethargy
Suicide ideation
Feeling of hopelessness
Lack of interest in activities that the person normally enjoys
Swelling or tenderness in the breast
Pain in the muscles and joints
Headaches
Feeling bloated
Changes in appetite, such as overeating or having specific food cravings
Sleep disorders

There are various risk factors of PMDD, including:

Women who have a history of PMS
Women with anxiety
Women with a family history of postpartum depression and various other mental disorders
Lower education and cigarette smoking
Obesity
Thyroid disorder
Lack of physical exercise
Alcohol or substance abuse

Although PMDD itself is not deadly, its symptoms can have an adverse impact on the lives of patients. Experiencing PMDD may make it difficult for patients to have a normal social life, work, and healthy relationships. In fact, some causes of PMDD can also lead to suicidal thoughts.

PMDD diagnosis has been identified as a major risk of suicide attempts and suicide ideation [7]. In fact, a staggering 30% of women with PMDD have attempted suicide [8].

There is no definitive test for diagnosing premenstrual dysphoric disorder, making it challenging for medical professionals to treat it. In order to be diagnosed with PMDD, the patient must have both physical and emotional symptoms such as breast tenderness, bloating, mood swings, and depression. These symptoms should ideally occur before the onset of the menstrual period and disappear after the period.

Women may also be asked to keep a record of their feelings every day for two full menstrual cycles before they can be diagnosed with PMDD.

Various therapies may be proposed for PMDD. Treatment usually depends on the patient’s specific symptoms, their personal preferences, and if they have any plans of becoming pregnant.

Before taking medications, the doctor may first suggest lifestyle changes such as:

Getting exercise
Making changes to the diet
Improving one’s sleep schedule
Identifying stressful events and cutting them out
Reducing alcohol consumption
Quitting smoking
Minimizing the dependency on caffeine

The exact recommendations will be different for every patient and will depend on their personal circumstances and as well as experiences.

SSRIs are usually the first recommended treatment for PMDD because they have been shown to work with patients. They may be taken throughout the whole month or during the luteal phase. Normally, patients are advised to stop taking SSRIs gradually, but patients during the luteal phase may abruptly discontinue using SSRIs suddenly because the withdrawal symptoms are not as intense [9].

Another medical option is to take combined oral contraceptives (often referred to as ‘the pill’) to reduce the symptoms of PMDD. Oral contraceptives work by controlling or stopping the periods. With that said, there are conflicting reports about the effectiveness of the pill for treating PMDD. If the doctor believes that the medication may help, they may prescribe a three-month trial to test the treatment’s effectiveness.

The physical symptoms of PMDD, such as headache, muscle pains, and joint aches, may be managed with the help of painkillers or anti-inflammatory drugs. Patients may be able to get some of these without a doctor’s prescription. However, it is recommended that patients discuss this with a doctor or pharmacist to ensure they are suitable.

Finally, patients can also try talk therapy and counseling to manage the psychological symptoms of PMDD. Studies have shown that cognitive behavioral therapy may be effective for people with PMDD.

Types of Premenstrual dysphoric disorder coded under F32.81

A F32.81 code can be used for the following approximate synonyms:

Premenstrual dysphoric
Dysphoric disorder

As a concrete example, a patient diagnosed with premenstrual dysphoric disorder or dysphoric disorder would be coded with F32.81.

There are several advantages of upgrading to the ICD-10-CM classification system for diagnosing PMDD. For one, it allows healthcare experts to clearly differentiate between PMDD and PMS because the former is much more severe in its symptoms. This makes it easier for medical professionals to provide more effective treatments.

Another goal of ICD-10-CM is to simplify the storage and retrieval of medical histories for the patient, making it more organized and consistent.

Of course, the system isn’t without its disadvantages. For one, it can be expensive to upgrade to ICD-10 because service providers have been known to charge a premium. Also, while the system is undergoing upgrades, the healthcare organization may go through a slump in productivity.

Healthcare professionals and medical coders may also be required to upgrade their certifications in line with the ICD-10-CM. This means having to attend expensive classes and seminars and taking exams. In some cases, the exam for ICD-10-CM certification can be expensive. In some cases, inexperienced medical coders may misidentify a disease, which could expose the patient to the wrong medication (as well as any side effects associated with it).

Menstrual disorders excluded from ICD-10 F32.81

Premenstrual tension syndrome (PMS) shares similar symptoms with PMDD, including mood swings, breast tenderness, food cravings, depression, and anger. It is coded under N94.3 and is applicable to the following approximate synonyms:

Menstrual edema
Premenstrual swelling
Premenstrual syndrome

Premenstrual tension syndrome (PMS) can be differentiated from premenstrual dysphoric disorder (PMDD), which presents with a much more severe form of premenstrual syndrome. It is a severe and chronic condition that requires medical intervention, including life cycle changes and even medication to manage symptoms.

Conclusion

The ICD-10 code for PMDD is F32.81. It should not be confused with premenstrual tension syndrome (N94.3), which is less severe in its symptoms (both emotional and physical) [10]. Note that the ICD-10 codes discussed here are meant for reference purposes only and do not replace professional medical advice.

If you believe that you have PMDD, please visit a qualified doctor to get a proper diagnosis. You may also direct any health-related questions, including the ICD-10 codes disguised here, to your healthcare provider.