ICD-10 Coding for Pelvic Infection(N73.9, A54.24, A56.11)
Complete ICD-10-CM coding and documentation guide for Pelvic Infection. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pelvic Infection
N70-N77Primary Range
Inflammatory diseases of female pelvic organs
This range includes codes for various inflammatory conditions affecting the female pelvic organs, including PID.
Gonococcal infection
This range includes codes for infections caused by Neisseria gonorrhoeae, relevant for gonococcal PID.
Other sexually transmitted chlamydial diseases
This range includes codes for infections caused by Chlamydia trachomatis, relevant for chlamydial PID.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N73.9 | Female pelvic inflammatory disease, unspecified | Use when PID is diagnosed but the specific infectious organism is not identified. |
|
| A54.24 | Gonococcal pelvic inflammatory disease | Use when PID is confirmed to be caused by Neisseria gonorrhoeae. |
|
| A56.11 | Chlamydial pelvic inflammatory disease | Use when PID is confirmed to be caused by Chlamydia trachomatis. |
|
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 pelvic infection
Essential facts and insights about Pelvic Infection
Primary ICD-10-CM Codes for pelvic infection
Decision Criteria
clinical Criteria
- PID symptoms present without specific organism identification
Applicable To
- Unspecified pelvic inflammatory disease
Clinical Validation Requirements
- Clinical symptoms of PID without specific organism identification
- Negative STI tests
Code-Specific Risks
- May trigger audits if used without documented negative STI testing.
Coding Notes
- Ensure documentation includes symptoms and negative test results if organism is not identified.
A54.24 - Gonococcal pelvic inflammatory disease
Use when PID is confirmed to be caused by Neisseria gonorrhoeae.
Applicable To
- Pelvic inflammatory disease due to Neisseria gonorrhoeae
Excludes
- Chlamydial PID (A56.11)
- Unspecified PID (N73.9)
Clinical Validation Requirements
- Positive NAAT or culture for Neisseria gonorrhoeae
Coding Notes
Document specific test results confirming gonococcal infection.
A56.11 - Chlamydial pelvic inflammatory disease
Use when PID is confirmed to be caused by Chlamydia trachomatis.
Applicable To
- Pelvic inflammatory disease due to Chlamydia trachomatis
Excludes
- Gonococcal PID (A54.24)
- Unspecified PID (N73.9)
Clinical Validation Requirements
- Positive NAAT for Chlamydia trachomatis
Coding Notes
Document specific test results confirming chlamydial infection.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Pelvic and perineal pain
R10.2Streptococcus, group B, as the cause of diseases classified elsewhere
B95.2Escherichia coli [E. coli] as the cause of diseases classified elsewhere
B96.2Differential 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 Pelvic Infection to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N73.9.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Increases audit risk., Financial: Potential for claim denials.
Mitigation Strategy
Ensure all test results are documented in the patient record., Use templates to guide documentation.
Impact
Reimbursement: May result in lower reimbursement due to unspecified coding., Compliance: Increases risk of audit due to lack of specificity., Data Quality: Impacts data accuracy and quality for epidemiological tracking.
Mitigation Strategy
Document negative STI tests or specify symptoms if organism is not identified.
Impact
High audit risk when using N73.9 without documented negative STI tests.
Mitigation Strategy
Document all test results and symptoms clearly.
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 Pelvic Infection, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pelvic Infection
Use these documentation templates to ensure complete and accurate documentation for Pelvic Infection. These templates include all required elements for proper coding and billing.
Suspected PID with unknown organism
Specialty: GynecologyRequired Elements
- Patient history
- Symptom documentation
- Lab results
- Imaging findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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