2026 ICD-10-CM Diagnosis Code N95.1Menopausal and female climacteric states
ICD-10-CM Codes›N00–N99›N80-N98›N95
- Billable — Valid for Submission
- Chronic Condition
N95.1 is a billable ICD-10-CM diagnosis code for menopausal and female climacteric states. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 742 through 743, 760 through 761. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Menopausal disorders.
This medical diagnosis code is frequently used in OB/GYN medical specialties to designate conditions such selected menopausal and other perimenopausal disorders.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Climacteric flushing
- Dermatosis of menopause
- Difficulty managing menopause
- Menopausal concentration lack
- Menopausal flushing
- Menopausal headache
- Menopausal problem
- Menopausal sleeplessness
- Menopausal symptom
- Postmenopausal flushing
- Postmenopausal state
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Symptoms such as flushing, sleeplessness, headache, lack of concentration, associated with natural (age-related) menopause
Use Additional Code
- code for associated symptoms
Type 1 Excludes
- asymptomatic menopausal state Z78.0
- symptoms associated with artificial menopause E89.41
- symptoms associated with premature menopause E28.310
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
The “use additional code” indicates that a secondary code could be used to further specify the patient’s condition. This note is not mandatory and is only used if enough information is available to assign an additional code.
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
- Climacteric (female) - See Also: Menopause;
- symptoms (female) - N95.1
- menopausal - N95.1
- menopausal - N95.1
- Menopause, menopausal (asymptomatic) (state) - Z78.0
- symptomatic - N95.1
- Sleeplessness - See: Insomnia;
- menopausal - N95.1
- symptomatic - N95.1
- menopausal - Z78.0
- symptomatic - N95.1
- Symptoms NEC - R68.89
- menopausal - N95.1
- menopausal - N95.1
External Cause of Injuries IndexGuidance
References for this code in the External Cause of Injuries Index.
- 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
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Menopause
Menopause is the time in your life when you stop having your period and can no longer get pregnant. You have reached menopause when you have not had a period for 12 months.
The full article covers:
- What is menopause?
- What is early menopause?
- What are the symptoms of menopause?
- What are the treatments for the symptoms of menopause?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert N95.1 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About N95.1Overview
Is N95.1 (Menopausal and other perimenopausal disorders) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report menopausal and female climacteric states on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does N95.1 group to?
When menopausal and female climacteric states is the principal diagnosis on an inpatient stay, it groups to MS-DRG 742, 743, 760, 761, with relative weights from 0.5696 to 1.8348 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of N95.1?
Under the General Equivalence Mappings, menopausal and female climacteric states converts to ICD-9-CM 627.2 (sympt fem climact state). The mapping is a direct match.
Footnotes
[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:
- The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
- The condition places limitations on self-care, independent living, and social interactions.
