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N85.7 ICD-10-CM Code: Hematometra

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
1 inclusion term · 6 Excludes1

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 742 — UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC (MDC 13)
  • MS-DRG 743 — UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC (MDC 13)
  • MS-DRG 760 — MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC (MDC 13)
  • MS-DRG 761 — MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC (MDC 13)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for N85.7 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on N85.7 itself; “inherited from” names the category or block whose note applies here.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Hematosalpinx with hematometra

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Coder workflow for N85.7

MedCoder structured workflow — derived from this code’s own official record

Before you code N85.7

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with N85.7. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in N85.7’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewN89.7, N80, N71, N84.0, N81

Consider N85.7. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Official instructions as workflow

  • Excludes1 — check before selecting N85.7(6 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with N85.7: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareN89.7, N80, N71, N84.0, N81

    See the official tabular notes · Guidelines I.A.12.a

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition N85.7 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewN89.7, N80, N71, N84.0, N81

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Hematometra is a billable ICD-10-CM diagnosis code (N85.7).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (4)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name N85.7 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: N83.6 — Hematosalpinx.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 4 MS-DRGs: DRG 742 (MDC 13), DRG 743 (MDC 13), DRG 760 (MDC 13), DRG 761 (MDC 13).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):GEN025 — Other specified female genital disorders (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Other specified female genital disorders).

N84.8 — Polyp of other parts of female genital tract, N84.9 — Polyp of female genital tract, unspecified, N85.00 — Endometrial hyperplasia, unspecified, N85.01 — Benign endometrial hyperplasia, N85.02 — Endometrial intraepithelial neoplasia [EIN], N85.2 — Hypertrophy of uterus, N85.3 — Subinvolution of uterus, N85.4 — Malposition of uterus, N85.5 — Inversion of uterus, N85.6 — Intrauterine synechiae, N85.8 — Other specified noninflammatory disorders of uterus, N85.9 — Noninflammatory disorder of uterus, unspecified, N85.A — Isthmocele, N86 — Erosion and ectropion of cervix uteri, N87.0 — Mild cervical dysplasia, N87.1 — Moderate cervical dysplasia, N87.9 — Dysplasia of cervix uteri, unspecified, N88.0 — Leukoplakia of cervix uteri, N88.1 — Old laceration of cervix uteri, N88.2 — Stricture and stenosis of cervix uteri, +94 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Hemorrhage, hemorrhagic”, “Hematometra”, “Hemosalpinx”; these codes share that main term but sit in a different category of the Tabular List.

N32.89 — Other specified disorders of bladder (bladder), N36.8 — Other specified disorders of urethra (urethra), N42.1 — Congestion and hemorrhage of prostate (prostate), N48.89 — Other specified disorders of penis (penis), N50.1 — Vascular disorders of male genital organs (testis), N64.59 — Other signs and symptoms in breast (nipple), N83.0 — Follicular cyst of ovary (graafian follicle cyst), N83.1 — Corpus luteum cyst (corpus luteumcyst), N83.6 — Hematosalpinx, N83.8 — Other noninflammatory disorders of ovary, fallopian tube and broad ligament (ovary NEC), N88.8 — Other specified noninflammatory disorders of cervix uteri (cervix NEC), N89.7 — Hematocolpos (with hematocolpos), N90.89 — Other specified noninflammatory disorders of vulva and perineum (vulva), N92.1 — Excessive and frequent menstruation with irregular cycle (intermenstrual, irregular), N92.2 — Excessive menstruation at puberty (uterus, uterine, pubertal), N92.3 — Ovulation bleeding (intermenstrual), N92.4 — Excessive bleeding in the premenopausal period (uterus, uterine, climacteric), N93.8 — Other specified abnormal uterine and vaginal bleeding (uterus, uterine, prepubertal), N93.9 — Abnormal uterine and vaginal bleeding, unspecified (vagina), N94.89 — Other specified conditions associated with female genital organs and menstrual cycle (intrapelvic, female), +153 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of N85.7 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run N85.7 with these 2 related codes in Claim Check

Hierarchy

Excludes1

  • N89.7 — Hematocolpos[Excludes1]: “hematometra with hematocolpos (N89.7)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes1 notes

  • N83.6 — Hematosalpinx[Excludes1]: “hematometra (N85.7)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 13 — Diseases and Disorders of the Female Reproductive System[MDC crossing]: “Diseases and Disorders of the Female Reproductive System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 2,232 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Hematometra[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Hematosalpinx, with, hematometra[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Hemorrhage, hemorrhagic (concealed), intrauterine[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Hemosalpinx, with, hematometra[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (13)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "N85.7 — Hematometra." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/n85.7-hematometra

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Hematometra

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to N85.7 in its code family, with their registry titles.

View all codes in the N85 family