ICD-10 Coding for Norovirus(A08.11, A08.19)
Complete ICD-10-CM coding and documentation guide for Norovirus. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Norovirus
A08-A09Primary Range
Viral and other specified intestinal infections
This range includes codes for viral gastroenteritis, with A08.11 specifically for norovirus.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A08.11 | Acute gastroenteropathy due to Norwalk agent | Use when norovirus is confirmed by lab tests such as PCR. |
|
| A08.19 | Acute gastroenteropathy due to other small round viruses | Use when norovirus is suspected but not yet confirmed by lab tests. |
|
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 norovirus
Essential facts and insights about Norovirus
Primary ICD-10-CM Codes for norovirus
Decision Criteria
clinical Criteria
- PCR confirmation of Norwalk agent
documentation Criteria
- Documented outbreak context
Applicable To
- Norovirus infection
Excludes
- Influenza with gastrointestinal symptoms
Clinical Validation Requirements
- PCR confirmation of Norwalk agent
- Symptom duration 12-60 hours
- Outbreak context
Code-Specific Risks
- Using without lab confirmation
Coding Notes
- Ensure lab confirmation of norovirus before using A08.11.
A08.19 - Acute gastroenteropathy due to other small round viruses
Use when norovirus is suspected but not yet confirmed by lab tests.
Applicable To
- Suspected norovirus without lab confirmation
Excludes
- Confirmed norovirus infection (A08.11)
Clinical Validation Requirements
- Negative rotavirus test
- CART criteria documentation
Coding Notes
Transition to A08.11 upon lab confirmation.
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.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Norovirus to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A08.11.
Impact
Clinical: Misleading clinical data on norovirus prevalence., Regulatory: Non-compliance with ICD-10 coding guidelines., Financial: Potential claim denials.
Mitigation Strategy
Always confirm with lab tests before coding., Educate staff on documentation requirements.
Impact
Reimbursement: Potential denial of claims due to lack of lab confirmation., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on norovirus prevalence.
Mitigation Strategy
Ensure PCR or other lab tests confirm norovirus before coding.
Impact
Lack of lab confirmation for norovirus coding.
Mitigation Strategy
Implement checks to ensure lab results are documented before coding.
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 Norovirus, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Norovirus
Use these documentation templates to ensure complete and accurate documentation for Norovirus. These templates include all required elements for proper coding and billing.
Emergency Department Visit for Norovirus
Specialty: Emergency MedicineRequired Elements
- Exposure history
- Symptom profile
- Lab correlation
- Outbreak measures
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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