Endometriosis ICD-10: Coding Guidance for Women’s Health Care

For many women, endometriosis shapes daily function long before it is clearly reflected in the medical record, and endometriosis ICD-10 coding is often the first place where this complexity must be captured. Chronic pelvic pain, painful intercourse, bowel symptoms, and fatigue often lead to repeated care visits across gynecology, rehabilitation, and pain management.

In these cases, accurate endometriosis ICD-10 coding plays a key role in documenting care, supporting care coordination, and aligning clinical services with reimbursement requirements. When diagnosis codes fail to reflect disease location or functional impact, gaps can emerge in communication, reporting, and continuity of care.

This article reviews how endometriosis is classified within ICD-10-CM, explains distinctions among code categories, and outlines documentation considerations relevant to women’s health services. An applied coding example is included to demonstrate appropriate code selection in clinical practice.

Understanding endometriosis in women’s healthcare

Endometriosis is a chronic inflammatory condition in which endometrial-like tissue grows outside the uterine cavity, most commonly affecting the ovaries, fallopian tubes, pelvic peritoneum, and surrounding structures.

Globally, endometriosis affects an estimated 10 percent of reproductive-age women—approximately 190 million individuals worldwide.¹

Clinically, endometriosis is associated with a wide range of symptoms, including:

• Pelvic pain and chronic pelvic pain

• Dysmenorrhea

• Dyspareunia

• Bowel or bladder dysfunction

• Fatigue

Symptom severity does not always correlate with disease extent. Many patients experience significant functional limitations even when imaging or surgical findings appear limited.²

Because endometriosis often presents across gynecologic, musculoskeletal, and visceral systems, patients may seek care in multiple settings over time, contributing to delayed diagnosis, fragmented care, and prolonged symptom burden.

For clinicians, understanding how endometriosis affects pain, movement, and participation is essential not only for treatment planning but also for accurate documentation. A clear clinical context supports more precise ICD-10 coding and helps ensure that the condition's functional impact is reflected in the medical record.

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Classifying endometriosis in ICD-10-CM

In ICD-10-CM, endometriosis is classified under Chapter 14: Diseases of the Genitourinary System, within category N80 – Endometriosis. These diagnosis codes describe the presence of endometrial-like tissue outside the uterine cavity and identify the anatomic location.

ICD-10-CM offers greater specificity than prior coding systems by allowing clinicians and administrators to distinguish endometriosis by site, such as ovarian, tubal, pelvic peritoneal, intestinal, or unspecified locations. This specificity supports clearer documentation and more consistent reporting across care settings.

Endometriosis codes describe the condition itself rather than the intervention provided. Code selection depends on provider documentation, imaging findings, surgical confirmation, or a documented history included in the medical record.

Endometriosis ICD-10 code categories and descriptions

The N80 category includes multiple subcodes that define the location of endometriotic lesions.

Common endometriosis ICD-10 codes

• N80.0 – Endometriosis of uterus

• N80.1 – Endometriosis of the ovary

• N80.2 – Endometriosis of the fallopian tube

• N80.3 – Endometriosis of pelvic peritoneum

• N80.4 – Endometriosis of rectovaginal septum and vagina

• N80.5 – Endometriosis of intestine

• N80.6 – Endometriosis in cutaneous scar

• N80.8 – Other endometriosis

• N80.9 – Endometriosis, unspecified

When documentation identifies involvement at more than one anatomic site, multiple N80 codes may be reported if supported by the record. When location is not specified, N80.9 may be used, although greater specificity is preferred when available.

Clinical documentation may also reference adhesions, chronic pelvic pain, infertility, or gastrointestinal involvement. These findings may support additional diagnosis codes when they are actively addressed during care.

Documentation considerations for women’s health services

Endometriosis frequently presents with musculoskeletal, pelvic floor, and visceral symptoms that extend beyond gynecologic care alone, intersecting with pain management, activity limitations, and participation restrictions.

This makes clear diagnostic coding especially important when care plans target function, symptom control, or quality of life—not just gynecologic pathology.

For accurate endometriosis ICD-10 coding, documentation should clearly indicate:

• A confirmed diagnosis or documented history of endometriosis

• The anatomic location, if known

• The relationship between endometriosis and presenting symptoms

• Whether the condition is current, recurrent, or part of past medical history

Although endometriosis is a chronic condition, ICD-10 coding should reflect relevance to the current episode of care. When symptoms related to endometriosis are being addressed, the diagnosis may be reported as primary or secondary, depending on the treatment focus.

Associated symptom codes, such as pelvic pain (R10.2) or dysmenorrhea (N94.6), may be reported when documented and managed separately. Coding decisions should align with payer guidance and documentation standards.

Why accurate endometriosis ICD-10 coding matters

Consistent ICD-10 coding supports more than billing and reimbursement. It helps ensure that the clinical story of a patient’s condition—and its functional impact—is accurately reflected across care settings.

Accurate coding helps to:

• Support medical necessity for services addressing pain or functional limitations

• Improve communication across interdisciplinary care teams

• Reflect the chronic nature of the condition in the clinical record

• Strengthen data used for utilization and quality analysis

Given the diagnostic delays many patients experience, clear documentation and coding also help validate patient-reported symptoms and care history.¹

Example: applying endometriosis ICD-10 in practice

Clinical scenario

A 34-year-old patient presents to outpatient pelvic health physical therapy with a long history of chronic pelvic pain, painful intercourse, and activity-related symptom flares. She reports increasing difficulty tolerating prolonged sitting, exercise, and work tasks due to persistent pain and fatigue.

Her medical history includes laparoscopically confirmed ovarian endometriosis diagnosed three years earlier. Recent gynecologic notes document recurrent symptoms despite prior medical management. The current referral is for management of pain, pelvic floor dysfunction, and functional limitations affecting daily activities and participation.

During the initial evaluation, the clinician documents:

• Surgically confirmed ovarian endometriosis

• Ongoing pelvic and perineal pain

• Activity intolerance and participation restrictions related to pain

The plan of care focuses on pain management, pelvic floor rehabilitation, and graded return to functional activities.

Appropriate ICD-10 coding 

• N80.1 – Endometriosis of the ovary

• R10.2 – Pelvic and perineal pain (when documented and treated as a distinct clinical problem)

In this scenario, N80.1 reflects the underlying chronic diagnosis driving the episode of care, while R10.2 captures the primary symptom addressed during treatment. Reporting both codes accurately represents disease etiology and functional impact, provided documentation supports each diagnosis.

This approach supports medical necessity for therapy services, improves communication across care teams, and ensures that both the structural diagnosis and the patient’s pain-related functional limitations are clearly reflected in the medical record.

Supporting continuity in endometriosis care

For patients with endometriosis, ICD-10 coding often marks the beginning of a longer care trajectory rather than a single episode. Chronic pelvic pain, recurrent symptoms, and functional limitations frequently require ongoing conservative management across multiple settings.

In this context, accurate endometriosis ICD-10 documentation helps identify patients who may benefit from structured support between visits. Clear coding of disease location and symptom burden creates a foundation for targeted pelvic health programs that extend care beyond the clinic.

Medbridge’s Women’s Health Pathways support this transition by extending evidence-based pelvic healthcare into the home through guided education and symptom-specific digital programs aligned with common challenges in endometriosis care, including:

• Chronic pelvic pain and activity intolerance

• Post-surgical recovery

• Pelvic floor dysfunction and dyspareunia

• Bladder and bowel symptoms

By reinforcing care between visits, Pathways helps maintain continuity and support long-term management without increasing clinical burden.

Clinical takeaways for using endometriosis ICD-10

Endometriosis is a complex women’s health condition with multiple ICD-10-CM coding options based on anatomic location. Selecting the correct endometriosis ICD-10 code depends on clear documentation, awareness of code distinctions, and alignment with the clinical focus of care.

Using site-specific N80 codes when supported by documentation improves clarity, supports reporting accuracy, and helps ensure that the functional impact of endometriosis is accurately reflected in the medical record.

References

1. World Health Organization. (2023, March 16). Endometriosis. https://www.who.int/news-room/fact-sheets/detail/endometriosis

2. American College of Obstetricians and Gynecologists. (2010, July). Management of endometriosis (Practice Bulletin No. 114).https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2010/07/management-of-endometriosis