ICD-10 Coding for Mastocytosis(D47.02, C96.21, D47.01, Q82.2)
Complete ICD-10-CM coding and documentation guide for Mastocytosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Mastocytosis
D47.0-D47.9Primary Range
Other neoplasms of uncertain behavior of lymphoid, hematopoietic and related tissue
This range includes codes for systemic and cutaneous mastocytosis, which are primary conditions of interest.
Malignant mast cell neoplasms
This range includes codes for aggressive systemic mastocytosis, which is a more severe form of the condition.
Congenital cutaneous mastocytosis
This code is used for congenital forms of cutaneous mastocytosis, indicating onset at birth.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D47.02 | Systemic mastocytosis | Use when systemic involvement is confirmed with bone marrow biopsy and elevated tryptase levels. |
|
| C96.21 | Aggressive systemic mastocytosis | Use when aggressive systemic involvement with organ damage is documented. |
|
| D47.01 | Cutaneous mastocytosis | Use when mastocytosis is limited to the skin without systemic involvement. |
|
| Q82.2 | Congenital cutaneous mastocytosis | Use when mastocytosis is present from birth. |
|
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 systemic mastocytosis
Essential facts and insights about Mastocytosis
Primary ICD-10-CM Codes for mastocytosis
Decision Criteria
clinical Criteria
- Presence of multifocal dense mast cell infiltrates in bone marrow
documentation Criteria
- Detailed biopsy and genetic test results
Applicable To
- Indolent systemic mastocytosis
- Smoldering systemic mastocytosis
Clinical Validation Requirements
- Bone marrow biopsy showing ≥15 mast cell aggregates
- KIT D816V mutation
- Serum tryptase >20 ng/mL
Code-Specific Risks
- Confusion with mast cell activation syndrome
- Inadequate documentation of systemic involvement
Coding Notes
- Ensure documentation specifies systemic involvement and genetic markers.
C96.21 - Aggressive systemic mastocytosis
Use when aggressive systemic involvement with organ damage is documented.
Applicable To
- Aggressive mast cell disease
Excludes
- Indolent systemic mastocytosis (D47.02)
Clinical Validation Requirements
- Organ damage such as cytopenias or hepatomegaly
- C-findings like ascites or hypoalbuminemia
Coding Notes
Ensure documentation of aggressive features and organ involvement.
D47.01 - Cutaneous mastocytosis
Use when mastocytosis is limited to the skin without systemic involvement.
Applicable To
- Urticaria pigmentosa
Excludes
- Congenital cutaneous mastocytosis (Q82.2)
Clinical Validation Requirements
- Positive Darier’s sign
- Skin biopsy with spindle-shaped mast cells
Coding Notes
Ensure documentation specifies skin involvement and biopsy results.
Q82.2 - Congenital cutaneous mastocytosis
Use when mastocytosis is present from birth.
Applicable To
- Congenital urticaria pigmentosa
Excludes
- Acquired cutaneous mastocytosis (D47.01)
Clinical Validation Requirements
- Documentation of congenital origin
- Presence since birth
Coding Notes
Ensure documentation specifies congenital onset.
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.
Other specified disorders involving the immune mechanism, not elsewhere classified
D89.8Systemic mastocytosis
D47.02Congenital cutaneous mastocytosis
Q82.2Cutaneous mastocytosis
D47.01Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Mastocytosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D47.02.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential loss of reimbursement.
Mitigation Strategy
Ensure detailed biopsy and laboratory findings are documented., Use specific terminology for systemic involvement.
Impact
Reimbursement: Incorrect coding may lead to improper DRG assignment., Compliance: May result in non-compliance with coding standards., Data Quality: Affects accuracy of patient records and data analysis.
Mitigation Strategy
Ensure documentation meets systemic mastocytosis criteria before coding.
Impact
Reimbursement: Incorrect code may affect reimbursement rates., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Leads to inaccurate patient data.
Mitigation Strategy
Confirm and document the onset of the condition.
Impact
Lack of detailed biopsy and laboratory findings.
Mitigation Strategy
Ensure comprehensive documentation of all diagnostic criteria.
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 Mastocytosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Mastocytosis
Use these documentation templates to ensure complete and accurate documentation for Mastocytosis. These templates include all required elements for proper coding and billing.
Systemic mastocytosis with bone marrow involvement
Specialty: HematologyRequired Elements
- Bone marrow biopsy results
- Serum tryptase levels
- KIT mutation status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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