ICD-10 Coding for Hives(L50.0, L50.1)
Complete ICD-10-CM coding and documentation guide for Hives. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hives
L50.0-L50.9Primary Range
Urticaria and erythema
This range includes all forms of urticaria, which are commonly referred to as hives.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| L50.0 | Allergic urticaria | Use when hives are confirmed to be due to an allergic reaction. |
|
| L50.1 | Idiopathic urticaria | Use when urticaria persists for more than 6 weeks with no identifiable cause. |
|
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 allergic hives
Essential facts and insights about Hives
Primary ICD-10-CM Codes for hives
Decision Criteria
clinical Criteria
- Confirmed allergic reaction with urticaria symptoms
Applicable To
- Hives due to allergic reaction
Excludes
- Contact dermatitis (L23-L25)
Clinical Validation Requirements
- Positive skin prick test
- Elevated serum IgE levels
Code-Specific Risks
- Misclassification if allergen is not documented
Coding Notes
- Ensure documentation specifies the allergen and reaction type.
L50.1 - Idiopathic urticaria
Use when urticaria persists for more than 6 weeks with no identifiable cause.
Applicable To
- Chronic idiopathic urticaria
Excludes
- Urticaria due to known causes
Clinical Validation Requirements
- CU Index ≥10
- Negative allergy panel
Coding Notes
Ensure chronicity and idiopathic nature are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other adverse food reactions, not elsewhere classified
T78.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hives to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code L50.0.
Impact
Clinical: Inaccurate diagnosis and treatment, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Always document known allergens, Use specific codes when possible
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies the type and cause of urticaria.
Impact
High risk of audit if unspecified codes are used when specific codes are applicable.
Mitigation Strategy
Ensure documentation supports the most specific code available.
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 Hives, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hives
Use these documentation templates to ensure complete and accurate documentation for Hives. These templates include all required elements for proper coding and billing.
Chronic idiopathic urticaria
Specialty: Allergy and ImmunologyRequired Elements
- History of present illness
- Physical exam findings
- Assessment and plan
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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