Delayed puberty

This code signifies a delay in the onset of secondary sexual characteristics beyond the expected age range. It indicates that pubertal development has not begun by age 13 in girls or age 14 in boys, or that it has started but not progressed normally. This can be due to various underlying causes, including constitutional delay, chronic illness, or hypogonadism.

Assign this code when a patient presents with a documented absence of pubertal development within the established age limits for their sex. This diagnosis is typically supported by a thorough clinical evaluation, including physical examination findings, hormone levels, and bone age assessment. It is appropriate for both primary and secondary delayed puberty.

• Differentiate from arrested puberty (E30.1), where development begins but ceases prematurely.
• Always code any underlying cause of delayed puberty, such as hypopituitarism (E23.0) or Klinefelter syndrome (Q98.0), as a primary diagnosis if known and applicable.
• Ensure documentation clearly specifies the patient's age and the absence or incomplete development of secondary sexual characteristics.