ICD-10 Coding for Genital Wart(A63.0, B07.9)
Complete ICD-10-CM coding and documentation guide for Genital Wart. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Genital Wart
A63-A64Primary Range
Other predominantly sexually transmitted diseases
This range includes codes for sexually transmitted infections, with A63.0 specifically for anogenital warts.
Viral infections characterized by skin and mucous membrane lesions
This range includes codes for viral warts and other viral skin infections, such as molluscum contagiosum.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A63.0 | Anogenital (venereal) warts | Use when genital warts are confirmed to be HPV-related and located in the anogenital region. |
|
| B07.9 | Viral wart, unspecified | Use when warts are not confirmed as HPV-related or lack specific anatomic documentation. |
|
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 warts
Essential facts and insights about Genital Wart
Primary ICD-10-CM Codes for genital wart
Decision Criteria
clinical Criteria
- Presence of cauliflower-like lesions in the anogenital area.
documentation Criteria
- Explicit mention of HPV or condyloma acuminatum.
Applicable To
- Condyloma acuminatum
- HPV-related genital warts
Clinical Validation Requirements
- HPV confirmation via PCR or biopsy
- Anatomic site documentation
Code-Specific Risks
- Incorrectly using B07.9 for HPV-confirmed cases
Coding Notes
- Ensure HPV confirmation and specific anatomic site are documented.
B07.9 - Viral wart, unspecified
Use when warts are not confirmed as HPV-related or lack specific anatomic documentation.
Applicable To
- Warts not specified as HPV-related
Excludes
- Anogenital warts (A63.0)
Clinical Validation Requirements
- Lack of specific HPV confirmation or anatomic site
Coding Notes
Avoid using for confirmed anogenital warts.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for screening for infections with a predominantly sexual mode of transmission
Z11.3Contact with and (suspected) exposure to infections with a predominantly sexual mode of transmission
Z20.2Papillomavirus as the cause of diseases classified elsewhere
B97.7Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Genital Wart to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A63.0.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials or reduced reimbursement.
Mitigation Strategy
Include detailed lesion descriptions in notes., Ensure documentation of HPV status.
Impact
Reimbursement: May lead to incorrect DRG assignment and reimbursement issues., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Use A63.0 when HPV is confirmed and the location is anogenital.
Impact
Claims for A63.0 without HPV confirmation are frequently audited.
Mitigation Strategy
Ensure HPV testing is documented before coding.
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 Wart, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Genital Wart
Use these documentation templates to ensure complete and accurate documentation for Genital Wart. These templates include all required elements for proper coding and billing.
Genital warts in a dermatology clinic
Specialty: DermatologyRequired Elements
- Patient history of warts
- Lesion description and location
- HPV test results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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