ICD-10 Coding for ESBL-producing E. coli Infection(Z16.12, A41.51, N39.0)
Complete ICD-10-CM coding and documentation guide for ESBL-producing E. coli Infection. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to ESBL-producing E. coli Infection
Z16-Z16.12Primary Range
Resistance to antimicrobial drugs
This range includes codes for resistance to antimicrobial drugs, specifically Z16.12 for ESBL resistance.
Sepsis due to E. coli
Used for coding sepsis caused by E. coli, including ESBL-producing strains.
Urinary tract infection, site not specified
Used for coding urinary tract infections, including those caused by ESBL-producing E. coli.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z16.12 | Resistance to extended-spectrum beta-lactamase (ESBL) | Use when ESBL-producing E. coli is confirmed via lab tests. |
|
| A41.51 | Sepsis due to Escherichia coli | Use when sepsis is confirmed to be caused by E. coli. |
|
| N39.0 | Urinary tract infection, site not specified | Use for UTIs confirmed to be caused by E. coli. |
|
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 ESBL-producing E. coli
Essential facts and insights about ESBL-producing E. coli Infection
Primary ICD-10-CM Codes for esbl physician initial coli
Decision Criteria
clinical Criteria
- ESBL production confirmed by lab tests
Applicable To
- ESBL resistance
Excludes
- Non-ESBL resistance
Clinical Validation Requirements
- Microbiology report confirming ESBL production
- Antimicrobial susceptibility testing showing resistance
Code-Specific Risks
- Incorrectly coding non-ESBL resistance as Z16.12
Coding Notes
- Ensure microbiology reports confirm ESBL production.
A41.51 - Sepsis due to Escherichia coli
Use when sepsis is confirmed to be caused by E. coli.
Applicable To
- Sepsis due to ESBL-producing E. coli
Excludes
- Sepsis due to other organisms
Clinical Validation Requirements
- Blood cultures confirming E. coli
- Clinical signs of sepsis
Coding Notes
Ensure sepsis is documented as due to E. coli.
N39.0 - Urinary tract infection, site not specified
Use for UTIs confirmed to be caused by E. coli.
Applicable To
- UTI due to ESBL-producing E. coli
Excludes
- UTI due to other specified organisms
Clinical Validation Requirements
- Urine culture confirming E. coli
- Symptoms of UTI
Coding Notes
Ensure UTI is documented as due to E. coli.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
ESBL flag code
U93Differential 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 ESBL-producing E. coli Infection to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z16.12.
Impact
Clinical: Incomplete documentation of resistance, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Review coding guidelines, Ensure U93 is included when applicable
Impact
Reimbursement: Incorrect sequencing can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate healthcare data reporting.
Mitigation Strategy
Ensure infection site or sepsis codes are primary, followed by Z16.12 and U93.
Impact
Incorrect coding of resistance can lead to audit findings.
Mitigation Strategy
Ensure lab confirmation and correct code 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 ESBL-producing E. coli Infection, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for ESBL-producing E. coli Infection
Use these documentation templates to ensure complete and accurate documentation for ESBL-producing E. coli Infection. These templates include all required elements for proper coding and billing.
Uncomplicated ESBL UTI
Specialty: Infectious DiseaseRequired Elements
- Patient symptoms
- Lab results
- Antibiotic resistance profile
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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