ICD-10 Coding for C. diff diarrhea(A04.7, A04.71, A04.72)
Complete ICD-10-CM coding and documentation guide for C. diff diarrhea. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to C. diff diarrhea
A00-B99Primary Range
Certain infectious and parasitic diseases
This range includes codes for infectious diseases, including C. diff infections.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A04.7 | Enterocolitis due to Clostridioides difficile | Use when C. diff infection is confirmed by lab tests and clinical symptoms are present. |
|
| A04.71 | Enterocolitis due to Clostridioides difficile with sepsis | Use when C. diff infection leads to sepsis. |
|
| A04.72 | Recurrent enterocolitis due to Clostridioides difficile | Use for recurrent episodes of C. diff within 8 weeks. |
|
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 C. diff diarrhea
Essential facts and insights about C. diff diarrhea
Primary ICD-10-CM Codes for c diff diarrhea
Decision Criteria
clinical Criteria
- Positive stool PCR or toxin assay
documentation Criteria
- ≥3 unformed stools in 24 hours
Applicable To
- Pseudomembranous colitis
Excludes
- Other specified bacterial intestinal infections
Clinical Validation Requirements
- Positive stool PCR or toxin assay
- ≥3 unformed stools in 24 hours
Code-Specific Risks
- Coding without lab confirmation
- Misclassification as hospital-acquired without proper documentation
Coding Notes
- Ensure documentation includes stool characteristics and lab confirmation.
A04.71 - Enterocolitis due to Clostridioides difficile with sepsis
Use when C. diff infection leads to sepsis.
Clinical Validation Requirements
- Positive blood culture for C. diff
- Sepsis criteria met
Coding Notes
Ensure sepsis is documented with C. diff as the cause.
A04.72 - Recurrent enterocolitis due to Clostridioides difficile
Use for recurrent episodes of C. diff within 8 weeks.
Clinical Validation Requirements
- Recurrent positive tests within 8 weeks
- Documented previous episodes
Coding Notes
Document recurrence and previous treatment history.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Resistance to vancomycin
Z16.11Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting C. diff diarrhea to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A04.7.
Impact
Clinical: Inadequate assessment of severity, Regulatory: Non-compliance with documentation standards, Financial: Potential claim denials
Mitigation Strategy
Use Bristol Stool Chart for documentation, Record stool frequency and consistency
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Ensure positive lab results are documented before coding.
Impact
Coding without documented lab results
Mitigation Strategy
Require lab results before coding C. diff
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 C. diff diarrhea, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for C. diff diarrhea
Use these documentation templates to ensure complete and accurate documentation for C. diff diarrhea. These templates include all required elements for proper coding and billing.
Hospital-acquired C. diff infection
Specialty: Infectious DiseaseRequired Elements
- Stool frequency and consistency
- Lab test results
- Antibiotic history
- Symptom onset timing
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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