ICD-10 Coding for Metapneumovirus(J12.2, J21.0, B97.81)
Complete ICD-10-CM coding and documentation guide for Metapneumovirus. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Metapneumovirus
J12-J18Primary Range
Pneumonia due to other infectious organisms
This range includes codes for pneumonia caused by viral infections, including hMPV.
Other acute lower respiratory infections
This range includes codes for acute bronchitis and bronchiolitis, which can be caused by hMPV.
Viral agents as the cause of diseases classified elsewhere
This range includes codes for identifying the viral agent responsible for the condition, such as hMPV.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| J12.2 | Viral pneumonia, not elsewhere classified | Use when pneumonia is confirmed to be caused by hMPV. |
|
| J21.0 | Acute bronchiolitis due to respiratory syncytial virus | Use when bronchiolitis is confirmed to be caused by hMPV. |
|
| B97.81 | Human metapneumovirus as the cause of diseases classified elsewhere | Use as a secondary code to specify hMPV as the cause of a condition. |
|
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 metapneumovirus
Essential facts and insights about Metapneumovirus
Primary ICD-10-CM Codes for metapneumovirus
Decision Criteria
clinical Criteria
- Confirmed hMPV infection via PCR
documentation Criteria
- Detailed documentation of respiratory symptoms and test results
Applicable To
- Pneumonia due to human metapneumovirus
Excludes
- Pneumonia due to other specified viruses
Clinical Validation Requirements
- PCR confirmation of hMPV
- Chest X-ray showing bilateral infiltrates
Code-Specific Risks
- Misclassification if organism is not specified
Coding Notes
- Ensure documentation specifies hMPV as the cause.
J21.0 - Acute bronchiolitis due to respiratory syncytial virus
Use when bronchiolitis is confirmed to be caused by hMPV.
Applicable To
- Acute bronchiolitis caused by human metapneumovirus
Excludes
- Bronchiolitis due to other specified viruses
Clinical Validation Requirements
- Positive rapid antigen test or PCR for hMPV
- Clinical presentation of bronchiolitis
Coding Notes
Ensure documentation specifies hMPV as the cause.
B97.81 - Human metapneumovirus as the cause of diseases classified elsewhere
Use as a secondary code to specify hMPV as the cause of a condition.
Applicable To
- hMPV as a causative agent
Excludes
- Other viral agents
Clinical Validation Requirements
- Laboratory confirmation of hMPV
Coding Notes
Always pair with a primary code for the respiratory condition.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Human metapneumovirus as the cause of diseases classified elsewhere
B97.81Differential 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 Metapneumovirus to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code J12.2.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Ensure laboratory confirmation is documented., Use specific ICD-10 codes for viral causes.
Impact
Reimbursement: Incorrect DRG assignment leading to reimbursement issues., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate representation of patient data.
Mitigation Strategy
Always use B97.81 as a secondary code with a primary respiratory condition code.
Impact
Using B97.81 as a primary code instead of secondary.
Mitigation Strategy
Educate coders on proper sequencing rules.
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 Metapneumovirus, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Metapneumovirus
Use these documentation templates to ensure complete and accurate documentation for Metapneumovirus. These templates include all required elements for proper coding and billing.
Acute respiratory infection in pediatric patient
Specialty: PediatricsRequired Elements
- Chief complaint and history of present illness
- Physical examination findings
- Laboratory and imaging results
- Diagnosis and treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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