ICD-10 Coding for Genital Herpes(A60.0, A60.01, A60.04)
Complete ICD-10-CM coding and documentation guide for Genital Herpes. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Genital Herpes
A60Primary Range
Anogenital herpesviral infections
This range covers all anogenital herpes infections, including specific sites like genitalia and perianal regions.
Screening and resistance codes
These codes are used for screening and documenting antimicrobial resistance related to herpes 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 |
|---|---|---|---|
| A60.0 | Herpesviral infection of genitalia and urogenital tract | Use when herpes infection is confirmed in the genital or urogenital tract. |
|
| A60.01 | Herpesviral infection of penis | Use when herpes infection is confirmed on the penis. |
|
| A60.04 | Herpesviral vulvovaginitis | Use when herpes infection is confirmed in the vulva or vagina. |
|
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 genital herpes
Essential facts and insights about Genital Herpes
Primary ICD-10-CM Codes for genital herpes
Decision Criteria
clinical Criteria
- Confirmed herpes infection via PCR or culture
Applicable To
- Herpesviral vulvovaginitis
- Herpesviral cervicitis
Excludes
- Herpesviral infection of other sites
Clinical Validation Requirements
- PCR positivity from lesion swab
- Type-specific IgG serology
Code-Specific Risks
- Misclassification if site is not specified
Coding Notes
- Ensure site specificity is documented to avoid using unspecified codes.
A60.01 - Herpesviral infection of penis
Use when herpes infection is confirmed on the penis.
Applicable To
- Penile herpes
Clinical Validation Requirements
- PCR positivity from penile lesion
Coding Notes
Document specific site to ensure correct code usage.
A60.04 - Herpesviral vulvovaginitis
Use when herpes infection is confirmed in the vulva or vagina.
Applicable To
- Vulvar herpes
- Vaginal herpes
Clinical Validation Requirements
- PCR positivity from vulvar or vaginal lesion
Coding Notes
Ensure documentation specifies vulvar or vaginal site.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Screening for STIs
Z11.3Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Candidal vulvovaginitis
B37.3Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Genital Herpes to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A60.0.
Impact
Clinical: Leads to inappropriate treatment plans., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Always specify the site of infection in documentation.
Impact
Reimbursement: May lead to incorrect billing and reimbursement issues., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies the site to use the correct specific code.
Impact
Using A60.9 when specific site is documented.
Mitigation Strategy
Ensure documentation includes specific site details.
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 Genital Herpes, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Genital Herpes
Use these documentation templates to ensure complete and accurate documentation for Genital Herpes. These templates include all required elements for proper coding and billing.
Primary herpesviral vulvovaginitis
Specialty: OB/GYNRequired Elements
- Site of infection
- Type of herpes (HSV-1 or HSV-2)
- Confirmation method (PCR, culture)
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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