ICD-10 Coding for Glycosylated Hemoglobin Screening(Z13.1, R73.09)
Complete ICD-10-CM coding and documentation guide for Glycosylated Hemoglobin Screening. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Glycosylated Hemoglobin Screening
Z13-Z13.9Primary Range
Encounter for screening for other diseases and disorders
This range includes codes for screening encounters, with Z13.1 specifically for diabetes mellitus screening.
Abnormal glucose
This range includes codes for abnormal glucose findings, such as prediabetes, which may be identified during screening.
Type 2 diabetes mellitus
This range includes codes for diagnosed diabetes, which may be identified if HbA1c levels are ≥6.5%.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z13.1 | Encounter for screening for diabetes mellitus | Use for asymptomatic patients undergoing routine diabetes screening. |
|
| R73.09 | Prediabetes | Use when screening reveals prediabetes. |
|
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 glycosylated hemoglobin screening
Essential facts and insights about Glycosylated Hemoglobin Screening
Primary ICD-10-CM Codes for glycosylated hemoglobin screening
Decision Criteria
clinical Criteria
- Patient is asymptomatic and has risk factors for diabetes.
coding Criteria
- Screening intent must be documented.
Applicable To
- Routine diabetes screening
Excludes
- Screening for diabetes in symptomatic patients
Clinical Validation Requirements
- Patient is asymptomatic
- Risk factors such as family history or obesity
Code-Specific Risks
- Incorrect use in symptomatic patients
Coding Notes
- Ensure documentation specifies the encounter is for screening.
R73.09 - Prediabetes
Use when screening reveals prediabetes.
Applicable To
- Impaired fasting glucose
- Impaired glucose tolerance
Excludes
- Diabetes mellitus (E11.-)
Clinical Validation Requirements
- HbA1c level between 5.7% and 6.4%
Coding Notes
Ensure HbA1c results are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Hemoglobin; glycosylated (A1C)
83036Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Glycosylated Hemoglobin Screening to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z13.1.
Impact
Clinical: Misinterpretation of patient care purpose., Regulatory: Potential audit issues., Financial: Denial of claims.
Mitigation Strategy
Use templates to ensure complete documentation.
Impact
Reimbursement: Claims may be denied if screening codes are used incorrectly., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records and data.
Mitigation Strategy
Use appropriate diagnostic codes such as E11.9 for symptomatic patients.
Impact
Using Z13.1 for diagnostic purposes.
Mitigation Strategy
Educate staff on proper code usage.
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 Glycosylated Hemoglobin Screening, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Glycosylated Hemoglobin Screening
Use these documentation templates to ensure complete and accurate documentation for Glycosylated Hemoglobin Screening. These templates include all required elements for proper coding and billing.
Routine Diabetes Screening
Specialty: Primary CareRequired Elements
- Patient demographics
- Risk factors
- Screening intent
- HbA1c results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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