ICD-10 Coding for Bacterial Endocarditis(I33.0, I01.1)
Complete ICD-10-CM coding and documentation guide for Bacterial Endocarditis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Bacterial Endocarditis
I30-I52Primary Range
Other forms of heart disease
This range includes codes for endocarditis, specifically I33.0 for acute and subacute bacterial endocarditis.
Bacterial and viral infectious agents
These codes are used to identify the specific infectious agent causing the endocarditis.
Complications of cardiac and vascular prosthetic devices, implants and grafts
This range includes codes for infections related to prosthetic heart valves.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I33.0 | Acute and subacute infective endocarditis | Use when there is confirmed bacterial infection of the heart valves. |
|
| I01.1 | Acute rheumatic endocarditis | Use when endocarditis is due to rheumatic fever. |
|
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 bacterial endocarditis
Essential facts and insights about Bacterial Endocarditis
Primary ICD-10-CM Codes for bacterial endocarditis
Decision Criteria
clinical Criteria
- Presence of vegetations on echocardiogram and positive blood cultures
documentation Criteria
- Specific mention of bacterial cause and affected valve
Applicable To
- Bacterial endocarditis
- Infective endocarditis
Excludes
- Rheumatic endocarditis (I01.1)
Clinical Validation Requirements
- Positive blood cultures for typical organisms
- Echocardiogram showing vegetations
Code-Specific Risks
- Incorrectly coding without confirming the infectious agent
Coding Notes
- Ensure documentation specifies the valve affected and the organism identified.
I01.1 - Acute rheumatic endocarditis
Use when endocarditis is due to rheumatic fever.
Applicable To
- Rheumatic endocarditis
Excludes
- Non-rheumatic endocarditis (I33.0)
Clinical Validation Requirements
- History of rheumatic fever
- Elevated ASO titers
Coding Notes
Ensure rheumatic fever history is documented.
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 Bacterial Endocarditis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I33.0.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Always confirm organism via lab results, Educate staff on documentation standards
Impact
Reimbursement: May lead to incorrect DRG assignment and reimbursement issues., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data and statistics.
Mitigation Strategy
Ensure blood cultures or other tests confirm the specific organism.
Impact
Failure to document the causative organism can lead to audit issues.
Mitigation Strategy
Ensure all lab results are included in the patient's record.
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 Bacterial Endocarditis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Bacterial Endocarditis
Use these documentation templates to ensure complete and accurate documentation for Bacterial Endocarditis. These templates include all required elements for proper coding and billing.
Acute bacterial endocarditis on native valve
Specialty: CardiologyRequired Elements
- Organism identified
- Valve affected
- Echocardiogram findings
- Blood culture results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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