ICD-10 Coding for Adult Failure to Thrive(R62.7)
Complete ICD-10-CM coding and documentation guide for Adult Failure to Thrive. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Adult Failure to Thrive
R60-R69Primary Range
General symptoms and signs
This range includes codes for symptoms and signs not elsewhere classified, including Adult Failure to Thrive.
Key Information: ICD-10 code for adult failure to thrive
Essential facts and insights about Adult Failure to Thrive
Primary ICD-10-CM Code for adult failure to thrive
Decision Criteria
clinical Criteria
- No single dominant condition explains decline.
coding Criteria
- Use when no definitive underlying condition is confirmed.
documentation Criteria
- Document specific symptoms and functional decline.
Applicable To
- Multifactorial decline in adults
Excludes
- Failure to thrive in children (R62.51)
Clinical Validation Requirements
- ≥5% unintentional weight loss in 3 months
- Functional decline (e.g., Katz ADL score ≤4)
- No single dominant condition explains decline
Code-Specific Risks
- Using as a primary diagnosis when a more specific condition is present can lead to claim denials.
Coding Notes
- Ensure documentation supports the multifactorial nature of the decline.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Major depressive disorder, single episode, unspecified
F32.9Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Adult Failure to Thrive to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R62.7.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Increases risk of audits and claim denials., Financial: Potential loss of reimbursement due to coding errors.
Mitigation Strategy
Use structured templates for documentation., Regular training on documentation standards.
Impact
Reimbursement: Incorrect coding can affect DRG assignments and lower reimbursement., Compliance: May lead to claim denials and audits., Data Quality: Impacts the accuracy of patient records.
Mitigation Strategy
Code the underlying condition first, such as dementia or heart failure.
Impact
Risk of audits if R62.7 is used as a primary diagnosis without supporting documentation.
Mitigation Strategy
Ensure thorough documentation of weight loss, functional decline, and exclusion of other diagnoses.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Adult Failure to Thrive, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Adult Failure to Thrive
Use these documentation templates to ensure complete and accurate documentation for Adult Failure to Thrive. These templates include all required elements for proper coding and billing.
Geriatric patient with unexplained weight loss and functional decline
Specialty: GeriatricsRequired Elements
- Weight trends
- Functional status
- Cognitive assessment
- Nutritional data
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Adult Failure to Thrive? Ask your questions below.