ICD-10 Coding for Granulomatosis with Polyangiitis(M31.30, M31.31)
Complete ICD-10-CM coding and documentation guide for Granulomatosis with Polyangiitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Granulomatosis with Polyangiitis
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M31.30 | Wegener's granulomatosis without renal involvement | Use when GPA is diagnosed without renal involvement. |
|
| M31.31 | Wegener's granulomatosis with renal involvement | Use when GPA is diagnosed with renal involvement. |
|
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 granulomatosis
Essential facts and insights about Granulomatosis with Polyangiitis
Primary ICD-10-CM Codes for granulomatosis
Decision Criteria
clinical Criteria
- No renal involvement confirmed by clinical assessment.
Applicable To
- Granulomatosis with polyangiitis without renal involvement
Excludes
- M31.31 (with renal involvement)
Clinical Validation Requirements
- Necrotizing granulomas on biopsy
- PR3-ANCA positivity
Code-Specific Risks
- Incorrectly coding when renal involvement is present.
Coding Notes
- Ensure documentation specifies absence of renal involvement.
M31.31 - Wegener's granulomatosis with renal involvement
Use when GPA is diagnosed with renal involvement.
Applicable To
- Granulomatosis with polyangiitis with renal involvement
Excludes
- M31.30 (without renal involvement)
Clinical Validation Requirements
- Necrotizing granulomas on biopsy
- PR3-ANCA positivity
- Renal biopsy showing glomerulonephritis
Coding Notes
Ensure renal involvement is clearly documented.
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 Granulomatosis with Polyangiitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M31.30.
Impact
Clinical: May lead to misdiagnosis or incorrect treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.
Mitigation Strategy
Ensure ANCA results are included in all relevant documentation.
Impact
Reimbursement: Incorrect coding can lead to reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Ensure documentation clearly states whether renal involvement is present.
Impact
Lack of ANCA test documentation can trigger audits.
Mitigation Strategy
Ensure all ANCA test results are documented.
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 Granulomatosis with Polyangiitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Granulomatosis with Polyangiitis
Use these documentation templates to ensure complete and accurate documentation for Granulomatosis with Polyangiitis. These templates include all required elements for proper coding and billing.
GPA with renal involvement
Specialty: RheumatologyRequired Elements
- Biopsy findings
- ANCA test results
- Renal function tests
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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