ICD-10 Coding for Pelvic Inflammatory Disease(N73.9, A54.24, A56.11, A18.17)
Complete ICD-10-CM coding and documentation guide for Pelvic Inflammatory Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pelvic Inflammatory Disease
N70-N77Primary Range
Inflammatory diseases of female pelvic organs
This range includes codes for various inflammatory conditions of the female pelvic organs, including PID.
Sexually transmitted infections with a focus on gonococcal and chlamydial infections
This range includes codes for sexually transmitted infections that can cause PID, such as gonorrhea and chlamydia.
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 the specific organism causing PID is not identified. |
|
| A54.24 | Gonococcal PID | Use when PID is confirmed to be caused by Neisseria gonorrhoeae. |
|
| A56.11 | Chlamydial PID | Use when PID is confirmed to be caused by Chlamydia trachomatis. |
|
| A18.17 | Tuberculous PID | Use when PID is confirmed to be caused by tuberculosis. |
|
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 inflammatory disease
Essential facts and insights about Pelvic Inflammatory Disease
Primary ICD-10-CM Codes for pelvic inflammatory disease
Decision Criteria
clinical Criteria
- Use when PID is diagnosed without specific organism identification.
Clinical Validation Requirements
- Lower abdominal pain
- Cervical motion tenderness
- Negative STI testing
Code-Specific Risks
- Risk of under-coding if specific organism is known.
Coding Notes
- Ensure documentation specifies if the organism is unknown.
A54.24 - Gonococcal PID
Use when PID is confirmed to be caused by Neisseria gonorrhoeae.
Applicable To
- PID due to Neisseria gonorrhoeae
Excludes
- Chlamydial PID (A56.11)
Clinical Validation Requirements
- Positive NAAT or gram stain for Neisseria gonorrhoeae
- Mucopurulent discharge
Coding Notes
Ensure organism is documented as Neisseria gonorrhoeae.
A56.11 - Chlamydial PID
Use when PID is confirmed to be caused by Chlamydia trachomatis.
Applicable To
- PID due to Chlamydia trachomatis
Excludes
- Gonococcal PID (A54.24)
Clinical Validation Requirements
- Positive NAAT or PCR for Chlamydia trachomatis
- Pelvic tenderness
Coding Notes
Ensure organism is documented as Chlamydia trachomatis.
A18.17 - Tuberculous PID
Use when PID is confirmed to be caused by tuberculosis.
Applicable To
- PID due to tuberculosis
Clinical Validation Requirements
- Positive TB test
- Pelvic imaging showing tuberculous lesions
Coding Notes
Ensure TB is documented as the causative organism.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Personal history of PID
Z87.42Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Pelvic Inflammatory Disease 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., Regulatory: Non-compliance with coding standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Ensure lab results are reviewed and documented., Use specific codes when organism is identified.
Impact
Reimbursement: May lead to lower reimbursement due to unspecified coding., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Use organism-specific codes like A54.24 or A56.11 when the organism is confirmed.
Impact
Using N73.9 when specific organism is identified.
Mitigation Strategy
Ensure documentation includes organism identification.
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 Inflammatory Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pelvic Inflammatory Disease
Use these documentation templates to ensure complete and accurate documentation for Pelvic Inflammatory Disease. These templates include all required elements for proper coding and billing.
Emergency Department Visit for PID
Specialty: Emergency MedicineRequired Elements
- History of present illness
- Physical examination findings
- Laboratory results
- Imaging studies
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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