ICD-10 Coding for Ehlers-Danlos Syndrome(Q79.60, Q79.61, Q79.62, Q79.63)
Complete ICD-10-CM coding and documentation guide for Ehlers-Danlos Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ehlers-Danlos Syndrome
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Q79.60 | Ehlers-Danlos syndrome, unspecified | Use when the specific type of EDS is not documented or known. |
|
| Q79.61 | Classical Ehlers-Danlos syndrome | Use when classical EDS is confirmed by genetic testing and clinical criteria. |
|
| Q79.62 | Hypermobile Ehlers-Danlos syndrome | Use when hypermobile EDS is confirmed by clinical criteria. |
|
| Q79.63 | Vascular Ehlers-Danlos syndrome | Use when vascular EDS is confirmed by genetic testing and clinical criteria. |
|
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 Ehlers-Danlos Syndrome
Essential facts and insights about Ehlers-Danlos Syndrome
Primary ICD-10-CM Codes for ehlers-danlos syndrome
Decision Criteria
documentation Criteria
- Lack of specific EDS type documentation
Applicable To
- Unspecified type of Ehlers-Danlos Syndrome
Excludes
- Hypermobility syndrome (M35.7)
Clinical Validation Requirements
- Generalized joint hypermobility
- Skin hyperextensibility
Code-Specific Risks
- May lead to under-coding if specific type is known but not documented.
Coding Notes
- Ensure documentation supports the use of an unspecified code.
Q79.61 - Classical Ehlers-Danlos syndrome
Use when classical EDS is confirmed by genetic testing and clinical criteria.
Applicable To
- Classical EDS with skin hyperextensibility and atrophic scarring
Excludes
- Hypermobility syndrome (M35.7)
Clinical Validation Requirements
- COL5A1 or COL5A2 mutation
- Skin hyperextensibility
- Atrophic scarring
Coding Notes
Genetic testing results should be documented to support this code.
Q79.62 - Hypermobile Ehlers-Danlos syndrome
Use when hypermobile EDS is confirmed by clinical criteria.
Applicable To
- Hypermobile EDS with joint hypermobility and systemic manifestations
Excludes
- Hypermobility syndrome (M35.7)
Clinical Validation Requirements
- Beighton score ≥5/9
- Systemic manifestations such as chronic pain or dysautonomia
Coding Notes
Ensure Beighton score and systemic manifestations are documented.
Q79.63 - Vascular Ehlers-Danlos syndrome
Use when vascular EDS is confirmed by genetic testing and clinical criteria.
Applicable To
- Vascular EDS with arterial rupture risk
Excludes
- Hypermobility syndrome (M35.7)
Clinical Validation Requirements
- COL3A1 mutation
- Family history of vascular rupture
Coding Notes
Genetic testing results should be documented to support this code.
Differential 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 Ehlers-Danlos Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Q79.60.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Ensure genetic test results are included in patient records., Verify documentation before coding.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Potential non-compliance with coding guidelines., Data Quality: Decreased accuracy in health records.
Mitigation Strategy
Ensure specific EDS type is coded when documentation supports it.
Impact
High risk of audit if unspecified codes are used without justification.
Mitigation Strategy
Ensure specific EDS type is documented and coded.
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 Ehlers-Danlos Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ehlers-Danlos Syndrome
Use these documentation templates to ensure complete and accurate documentation for Ehlers-Danlos Syndrome. These templates include all required elements for proper coding and billing.
Orthopedic evaluation for hypermobile EDS
Specialty: OrthopedicsRequired Elements
- Joint hypermobility assessment
- Systemic manifestations documentation
- Exclusion of other connective tissue disorders
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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