ICD-10 Coding for Exposure to Tuberculosis(Z20.1, Z11.1, R76.11)
Complete ICD-10-CM coding and documentation guide for Exposure to Tuberculosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Exposure to Tuberculosis
Z20-Z29Primary Range
Persons with potential health hazards related to communicable diseases
This range includes codes for exposure to communicable diseases, including tuberculosis.
Abnormal immunological findings in serum without diagnosis
This range includes codes for nonspecific reactions to tuberculosis tests.
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 a patient has been exposed to a confirmed TB case but does not have active TB. |
|
| Z11.1 | Encounter for screening for respiratory tuberculosis | Use for encounters specifically for TB screening without symptoms. |
|
| R76.11 | Nonspecific reaction to tuberculin skin test without active tuberculosis | Use when a TST is positive but there is no evidence of active TB. |
|
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 exposure to tuberculosis
Essential facts and insights about Exposure to Tuberculosis
Primary ICD-10-CM Codes for exposure to tuberculosis
Decision Criteria
clinical Criteria
- Patient has been in contact with a confirmed TB case.
documentation Criteria
- Exposure details are clearly documented.
Applicable To
- Exposure to tuberculosis
Excludes
- History of tuberculosis (Z86.15)
Clinical Validation Requirements
- Documented contact with a confirmed TB case
- Exposure setting and duration
Code-Specific Risks
- Incorrectly used for patients with a history of TB without current exposure.
Coding Notes
- Ensure documentation specifies the exposure details, including the source case's infectious status.
Z11.1 - Encounter for screening for respiratory tuberculosis
Use for encounters specifically for TB screening without symptoms.
Applicable To
- Screening for active TB
Excludes
- Diagnostic testing for TB (Z11.7)
Clinical Validation Requirements
- Screening encounter documented
- No symptoms of active TB
Coding Notes
Ensure the encounter is documented as a screening visit.
R76.11 - Nonspecific reaction to tuberculin skin test without active tuberculosis
Use when a TST is positive but there is no evidence of active TB.
Applicable To
- Positive PPD without active TB
Excludes
- Active tuberculosis (A15-A19)
Clinical Validation Requirements
- TST result documented
- No symptoms of active TB
Coding Notes
Document the TST result in millimeters.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
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 Exposure to Tuberculosis 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 inappropriate follow-up care., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Train staff on detailed documentation, Use standardized templates
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Use Z22.7 for latent TB diagnosis, not exposure.
Impact
Inadequate documentation of exposure details.
Mitigation Strategy
Implement detailed documentation protocols.
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 Exposure to Tuberculosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Exposure to Tuberculosis
Use these documentation templates to ensure complete and accurate documentation for Exposure to Tuberculosis. These templates include all required elements for proper coding and billing.
Occupational Health Screening
Specialty: Occupational MedicineRequired Elements
- Exposure details
- Test type and results
- Symptoms assessment
- Plan for follow-up
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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