ICD-10 Coding for Personal History of Alcohol Abuse(Z86.59, F10.11)
Complete ICD-10-CM coding and documentation guide for Personal History of Alcohol Abuse. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Personal History of Alcohol Abuse
Z86.51-Z86.59Primary Range
Personal history of mental and behavioral disorders
This range includes codes for personal history of mental and behavioral disorders, including alcohol abuse.
Mental and behavioral disorders due to use of alcohol
This range includes codes for current and past alcohol use disorders, including those in remission.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z86.59 | Personal history of other mental and behavioral disorders | Use when documenting a patient's past alcohol abuse that impacts current care but is not active. |
|
| F10.11 | Alcohol abuse, in remission | Use when the patient is in remission from alcohol abuse and this status is actively managed. |
|
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 personal history of alcohol abuse
Essential facts and insights about Personal History of Alcohol Abuse
Primary ICD-10-CM Codes for personal history of alcohol abuse
Decision Criteria
documentation Criteria
- Explicit statement of past alcohol abuse impacting current care
Applicable To
- History of alcohol abuse
Excludes
- Current alcohol abuse (F10.1-)
Clinical Validation Requirements
- Provider documentation linking history to current care
- Evidence of past treatment or rehabilitation
Code-Specific Risks
- Using without linking to current care
- Confusing with active alcohol abuse codes
Coding Notes
- Ensure documentation clearly states the history's impact on current health status.
F10.11 - Alcohol abuse, in remission
Use when the patient is in remission from alcohol abuse and this status is actively managed.
Applicable To
- Alcohol abuse in sustained remission
Excludes
- Current alcohol abuse (F10.1-)
Clinical Validation Requirements
- Documentation of remission status
- Evidence of ongoing monitoring or treatment
Coding Notes
Ensure remission status and management are clearly documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Family history of alcohol abuse
Z81.1Differential 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 Personal History of Alcohol Abuse to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z86.59.
Impact
Clinical: Inadequate patient management., Regulatory: Potential audit issues., Financial: Denied claims due to insufficient documentation.
Mitigation Strategy
Use specific dates and remission status, Link history to current conditions
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Use F10.1- codes for active abuse
Impact
Using Z86.59 without linking to current care can trigger audits.
Mitigation Strategy
Ensure all documentation clearly connects history to current health status.
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 Personal History of Alcohol Abuse, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Personal History of Alcohol Abuse
Use these documentation templates to ensure complete and accurate documentation for Personal History of Alcohol Abuse. These templates include all required elements for proper coding and billing.
Gastroenterology consultation for liver disease
Specialty: GastroenterologyRequired Elements
- History of alcohol use
- Current liver function tests
- Impact of alcohol history on liver condition
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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