ICD-10 Coding for Aneurysm(I71.1, I71.4)
Complete ICD-10-CM coding and documentation guide for Aneurysm. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Aneurysm
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I71.1 | Ruptured thoracic aortic aneurysm | Use when there is a confirmed rupture of the thoracic aorta. |
|
| I71.4 | Abdominal aortic aneurysm, without rupture | Use when an abdominal aortic aneurysm is present without rupture. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for ruptured thoracic aortic aneurysm
Essential facts and insights about Aneurysm
Primary ICD-10-CM Codes for aneurysm
Decision Criteria
clinical Criteria
- Presence of rupture confirmed by imaging
Applicable To
- Ruptured aneurysm of thoracic aorta
Excludes
- Traumatic aneurysm of thoracic aorta (S25.09)
Clinical Validation Requirements
- CT/MRI confirmation of rupture location
- Documentation of hemodynamic instability
Code-Specific Risks
- Misidentifying rupture status without imaging confirmation
Coding Notes
- Ensure rupture status is clearly documented.
I71.4 - Abdominal aortic aneurysm, without rupture
Use when an abdominal aortic aneurysm is present without rupture.
Applicable To
- Aneurysm of abdominal aorta without rupture
Excludes
- Ruptured abdominal aortic aneurysm (I71.3)
Clinical Validation Requirements
- Ultrasound showing diameter ≥3 cm
- No evidence of dissection on imaging
Coding Notes
Document the size and location of the aneurysm.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Aneurysm to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I71.1.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with ICD-10 coding guidelines., Financial: Incorrect billing and potential revenue loss.
Mitigation Strategy
Always document the specific location of the aneurysm., Use imaging to confirm and document findings.
Impact
Reimbursement: May lead to incorrect DRG assignment and reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient care.
Mitigation Strategy
Always confirm aneurysm location and rupture status with imaging.
Impact
Inadequate documentation of rupture status can lead to audit issues.
Mitigation Strategy
Ensure all imaging and clinical notes clearly state rupture status.
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 Aneurysm, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Aneurysm
Use these documentation templates to ensure complete and accurate documentation for Aneurysm. These templates include all required elements for proper coding and billing.
Unruptured abdominal aortic aneurysm
Specialty: Vascular SurgeryRequired Elements
- Location and size of aneurysm
- Imaging results
- Rupture status
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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