ICD-10 Coding for Close Contact with Quantiferon Positive(Z20.1, R76.12)
Complete ICD-10-CM coding and documentation guide for Close Contact with Quantiferon Positive. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Close Contact with Quantiferon Positive
Z20-Z22Primary Range
Contact with and (suspected) exposure to communicable diseases
This range includes codes for contact with and exposure to communicable diseases, including tuberculosis.
Other abnormal immunological findings in serum
This range includes codes for nonspecific reactions to tests for tuberculosis, such as a positive Quantiferon test.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z20.1 | Contact with and (suspected) exposure to tuberculosis | Use when the patient is being evaluated due to exposure to a confirmed TB case. |
|
| R76.12 | Nonspecific reaction to cell-mediated immunity measurement of gamma interferon antigen response without active tuberculosis | Use when the Quantiferon test is positive, but active TB is ruled out. |
|
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 close contact with Quantiferon positive
Essential facts and insights about Close Contact with Quantiferon Positive
Primary ICD-10-CM Codes for close contact with quantiferon positive
Decision Criteria
clinical Criteria
- Patient has documented exposure to a TB case.
documentation Criteria
- Absence of symptoms of active TB must be documented.
Applicable To
- Close contact with TB case
Excludes
- Active TB disease (A15-A19)
Clinical Validation Requirements
- Documented close contact with a confirmed TB case
- No symptoms of active TB
Code-Specific Risks
- Incorrectly using as primary code when the focus is on the test result.
Coding Notes
- Ensure documentation specifies the nature and duration of contact.
R76.12 - Nonspecific reaction to cell-mediated immunity measurement of gamma interferon antigen response without active tuberculosis
Use when the Quantiferon test is positive, but active TB is ruled out.
Applicable To
- Positive Quantiferon-TB Gold test
Excludes
- Active TB disease (A15-A19)
Clinical Validation Requirements
- Quantiferon-TB Gold result ≥0.35 IU/mL
- Normal chest X-ray
Coding Notes
Ensure test results and absence of active TB symptoms are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for testing for latent tuberculosis infection
Z11.7Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Close Contact with Quantiferon Positive to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z20.1.
Impact
Clinical: May lead to unnecessary treatment or follow-up., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Ensure thorough documentation of symptom assessment.
Impact
Reimbursement: Incorrect sequencing can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on TB exposure and testing.
Mitigation Strategy
Sequence Z20.1 as the primary code when the encounter is due to exposure.
Impact
Using R76.12 as primary when Z20.1 should be primary.
Mitigation Strategy
Review coding guidelines for proper sequencing.
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 Close Contact with Quantiferon Positive, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Close Contact with Quantiferon Positive
Use these documentation templates to ensure complete and accurate documentation for Close Contact with Quantiferon Positive. These templates include all required elements for proper coding and billing.
Primary Care Visit for TB Exposure
Specialty: Primary CareRequired Elements
- Patient exposure details
- Quantiferon test results
- Chest X-ray findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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