ICD-10 Coding for History of C. diff(Z86.19)
Complete ICD-10-CM coding and documentation guide for History of C. diff. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to History of C. diff
Z86.1-Z86.19Primary Range
Personal history of certain other diseases
This range includes codes for personal history of infectious and parasitic diseases, including C. diff.
Key Information: ICD-10 code for history of C. diff
Essential facts and insights about History of C. diff
Primary ICD-10-CM Code for history of c diff
Decision Criteria
clinical Criteria
- Patient has a documented history of C. diff with no current symptoms.
documentation Criteria
- Include details of past positive tests and treatment.
Applicable To
- History of Clostridioides difficile infection
Excludes
- Current or active Clostridioides difficile infection (A04.7-)
Clinical Validation Requirements
- Documented past positive test for C. diff toxin
- Treatment history for C. diff infection
Code-Specific Risks
- Misclassification as an active infection
- Omission of recurrence details in history
Coding Notes
- Ensure documentation specifies the history and not current infection.
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 History of C. diff to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z86.19.
Impact
Clinical: May lead to incorrect clinical assumptions., Regulatory: Non-compliance with documentation standards., Financial: Potential for incorrect billing.
Mitigation Strategy
Always document recurrence history if applicable., Review past medical records for accurate history.
Impact
Reimbursement: Incorrect coding can lead to improper DRG assignment., Compliance: May result in non-compliance with coding guidelines., Data Quality: Affects accuracy of patient records and data analytics.
Mitigation Strategy
Use Z86.19 for history and A04.7- codes for active infections.
Impact
Risk of coding history as active infection.
Mitigation Strategy
Ensure thorough review of patient history and symptoms.
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 History of C. diff, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for History of C. diff
Use these documentation templates to ensure complete and accurate documentation for History of C. diff. These templates include all required elements for proper coding and billing.
Primary Care Visit
Specialty: Family MedicineRequired Elements
- Patient history of C. diff infection
- Date of last positive test
- Treatment details
- Current symptom status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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