ICD-10 Coding for History of Hepatitis C(Z86.18, B94.2)
Complete ICD-10-CM coding and documentation guide for History of Hepatitis C. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to History of Hepatitis C
Z86.11-Z86.19Primary Range
Personal history of infectious and parasitic diseases
This range includes codes for personal history of infectious diseases, including hepatitis C.
Sequelae of viral hepatitis
Used for coding sequelae of hepatitis C, such as cirrhosis, after the infection has resolved.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z86.18 | Personal history of other infectious and parasitic diseases | Use when documenting a resolved case of hepatitis C with no active disease. |
|
| B94.2 | Sequelae of viral hepatitis | Use when documenting sequelae such as cirrhosis from a resolved hepatitis C infection. |
|
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 resolved hepatitis C
Essential facts and insights about History of Hepatitis C
Primary ICD-10-CM Codes for history of hepatitis c
Decision Criteria
clinical Criteria
- Patient has achieved sustained virologic response (SVR) with no active liver disease.
Applicable To
- History of resolved hepatitis C
Excludes
- Current hepatitis C infection (B18.2)
Clinical Validation Requirements
- HCV RNA negative on two occasions, at least 12 weeks apart post-treatment
Code-Specific Risks
- Incorrectly using for active hepatitis C cases
Coding Notes
- Ensure documentation clearly states 'resolved' or 'SVR' to use this code.
B94.2 - Sequelae of viral hepatitis
Use when documenting sequelae such as cirrhosis from a resolved hepatitis C infection.
Applicable To
- Cirrhosis due to past hepatitis C infection
Excludes
- Active hepatitis C infection (B18.2)
Clinical Validation Requirements
- Documented cirrhosis or other sequelae linked to past hepatitis C
Coding Notes
Ensure sequelae are directly linked to past hepatitis C infection.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting History of Hepatitis C to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z86.18.
Impact
Clinical: Misrepresentation of patient's current health status., Regulatory: Potential non-compliance with coding standards., Financial: Risk of denied claims due to insufficient documentation.
Mitigation Strategy
Ensure SVR status is documented in patient records., Regularly review documentation practices.
Impact
Reimbursement: Incorrect coding may lead to improper reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use Z86.18 for resolved cases without active disease.
Impact
Using B18.2 for patients with resolved hepatitis C.
Mitigation Strategy
Educate staff on correct coding for resolved hepatitis C.
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 Hepatitis C, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for History of Hepatitis C
Use these documentation templates to ensure complete and accurate documentation for History of Hepatitis C. These templates include all required elements for proper coding and billing.
Resolved Hepatitis C without Sequelae
Specialty: GastroenterologyRequired Elements
- Patient history
- HCV RNA test results
- Statement of resolution
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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