ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 N85.00

Billable / Specific

Endometrial hyperplasia, unspecified

N85
Block
2
Synonyms
3
LCDs
5
Payer Policies
2
Linked CPTs

About ICD-10-CM N85.00

ICD-10-CM code N85.00 represents Endometrial hyperplasia, unspecified. This is a billable/specific code in the Genitourinary System chapter (block N85). The 2026 edition of ICD-10-CM N85.00 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under N85.00. Per CMS ICD-10-CM Tabular 2026.

  • Hyperplasia (adenomatous) (cystic) (glandular) of endometrium
  • Hyperplastic endometritis

Medicare LCD Coverage for N85.00

Local Coverage Determinations (LCDs) from CMS MACs that list N85.00 as a covered diagnosis.

3 LCDs

Showing top 3. Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: IUD (Hormone-Eluting) for Endometrial Hyperplasia - CPT 58999
Article ID: 55061, Effective: 2025-09-25 00:00:00, 2 covered, 0 non-covered
CPT 58999 →
CMS LCD: Billing and Coding: Endometrial Hyperplasia Treatment with Intrauterine Device (Hormone-Eluting)
Article ID: 55951, Effective: 2026-02-26 00:00:00, 3 covered, 1 non-covered
CPT 58999 →
CMS LCD: Billing and Coding: Endometrial Hyperplasia Treatment
Article ID: 53043, Effective: 2023-01-01 00:00:00, 4 covered, 0 non-covered
CPT 58999 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing N85.00.

5 policies

4 Medicare

Billing and Coding: Endometrial Hyperplasia Treatment
Policy ID: ART-53043
Billing and Coding: IUD (Hormone-Eluting) for Endometrial Hyperplasia - CPT 58999
Policy ID: ART-55061
Billing and Coding: Endometrial Hyperplasia Treatment with Intrauterine Device (Hormone-Eluting)
Policy ID: ART-55951
Billing and Coding: IUD (Hormone-Eluting) for Endometrial Hyperplasia - CPT 58999
Policy ID: ART-58649

1 Aetna

Endometrial Cancer Screening, Diagnosis, and Prognosis
Policy ID: CPB-0769

CPT Codes Commonly Billed with N85.00

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

2 linkages
  • 58558 Hysteroscopy with biopsy — menorrhagia, irregular menses, excessive menstruation, endometrial polyp, endometrial hyperplasia, uterine fibroid, endometriosis of uterus, abnormal uterine bleeding OB/GYN
  • 58999 CMS LCD: Billing and Coding: Endometrial Hyperplasia Treatment CMS LCD

Convert N85.00 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
N85.00 62130 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 N85.00, Billing FAQ

Is ICD-10 code N85.00 billable? +

Yes, N85.00 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to N85.00? +

ICD-10 N85.00 includes: Hyperplasia (adenomatous) (cystic) (glandular) of endometrium; Hyperplastic endometritis.

What CPT codes are commonly billed with N85.00? +

Procedures frequently paired with N85.00 include: 58558, 58999.

What ICD-9 codes does N85.00 map to? +

Per CMS GEMs, N85.00 maps to ICD-9 codes: 62130. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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