ICD-10 Coding for History of Polycystic Ovary Syndrome(Z87.42, Z84.2)
Complete ICD-10-CM coding and documentation guide for History of Polycystic Ovary Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to History of Polycystic Ovary Syndrome
Z87-Z99Primary Range
Persons with potential health hazards related to family and personal history and certain conditions influencing health status
This range includes codes for personal history of diseases, including Z87.42 for personal history of PCOS.
Ovarian dysfunction
This range includes E28.2 for active PCOS, which is relevant for differentiating active from historical cases.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z87.42 | Personal history of diseases of the female genital organs | Use when PCOS is resolved or inactive, and it is relevant to the current care. |
|
| Z84.2 | Family history of diseases of the genitourinary system | Use when there is a documented family history of PCOS that impacts current care. |
|
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 history of PCOS
Essential facts and insights about History of Polycystic Ovary Syndrome
Primary ICD-10-CM Codes for history of pcos
Decision Criteria
clinical Criteria
- PCOS symptoms are resolved and no active treatment is ongoing.
documentation Criteria
- History of PCOS is linked to current clinical decision-making.
Applicable To
- Resolved PCOS
- Inactive PCOS
Excludes
- Active PCOS (E28.2)
Clinical Validation Requirements
- Documented resolution of PCOS symptoms
- No current treatment for PCOS
Code-Specific Risks
- Misuse for active PCOS cases
Coding Notes
- Ensure documentation clearly states the historical nature of PCOS and its relevance to current care.
Z84.2 - Family history of diseases of the genitourinary system
Use when there is a documented family history of PCOS that impacts current care.
Applicable To
- Family history of PCOS
Clinical Validation Requirements
- Documented family member with confirmed PCOS
Coding Notes
Ensure family history is documented with the degree of relation and confirmation of diagnosis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Family history of diseases of the genitourinary system
Z84.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting History of Polycystic Ovary Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z87.42.
Impact
Clinical: May miss relevance to current care., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Include history in assessment or plan.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records and data analytics.
Mitigation Strategy
Use Z87.42 for resolved or inactive PCOS cases.
Impact
Using active PCOS codes for historical cases.
Mitigation Strategy
Ensure documentation supports historical status and relevance.
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 Polycystic Ovary Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for History of Polycystic Ovary Syndrome
Use these documentation templates to ensure complete and accurate documentation for History of Polycystic Ovary Syndrome. These templates include all required elements for proper coding and billing.
Resolved PCOS in gynecology
Specialty: GynecologyRequired Elements
- Patient history of PCOS resolution
- Current symptoms or lack thereof
- Relevance to current care
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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