ICD-10 Coding for Orthostatic Tachycardia Syndrome(G90.A)
Complete ICD-10-CM coding and documentation guide for Orthostatic Tachycardia Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Orthostatic Tachycardia Syndrome
G90Primary Range
Disorders of autonomic nervous system
This range includes conditions related to autonomic nervous system dysfunction, including POTS.
Key Information: ICD-10 code for orthostatic tachycardia syndrome
Essential facts and insights about Orthostatic Tachycardia Syndrome
Primary ICD-10-CM Code for orthostatic tachycardia syndrome
Decision Criteria
clinical Criteria
- Heart rate increase and symptom resolution when supine
documentation Criteria
- Exclusion of other potential causes
Applicable To
- POTS
Excludes
- Orthostatic hypotension (I95.1)
Clinical Validation Requirements
- Sustained heart rate increase of ≥30 bpm (≥40 bpm for ages 12-19) within 10 minutes of standing
- Absence of orthostatic hypotension
- Symptoms improve when supine
- Duration of symptoms ≥3 months
- Exclusion of other causes such as anemia or hyperthyroidism
Code-Specific Risks
- Incorrectly coding symptoms instead of POTS
- Failure to document exclusion of other conditions
Coding Notes
- Ensure all diagnostic criteria are documented to support the use of G90.A.
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.
Orthostatic hypotension
I95.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Orthostatic Tachycardia Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G90.A.
Impact
Clinical: May lead to misdiagnosis., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Include lab results and clinical tests in documentation., Use structured templates for consistency.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Failure to comply with coding guidelines., Data Quality: Inaccurate representation of patient conditions.
Mitigation Strategy
Ensure POTS is documented with all criteria met and use G90.A as the primary code.
Impact
Incomplete documentation of diagnostic criteria for POTS.
Mitigation Strategy
Use checklists and templates to ensure all criteria are documented.
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 Orthostatic Tachycardia Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Orthostatic Tachycardia Syndrome
Use these documentation templates to ensure complete and accurate documentation for Orthostatic Tachycardia Syndrome. These templates include all required elements for proper coding and billing.
POTS Diagnosis in Cardiology
Specialty: CardiologyRequired Elements
- Orthostatic vital signs
- Symptom description
- Duration of symptoms
- Exclusion of other conditions
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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