ICD-10 Coding for Personal History of Pneumonia(Z87.01)
Complete ICD-10-CM coding and documentation guide for Personal History of Pneumonia. 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 Pneumonia
Z87.0-Z87.09Primary Range
Personal history of diseases of the respiratory system
This range includes codes for personal history of respiratory conditions, including recurrent pneumonia.
Key Information: ICD-10 code for personal history of pneumonia
Essential facts and insights about Personal History of Pneumonia
Primary ICD-10-CM Code for personal history of pneumonia
Decision Criteria
documentation Criteria
- Documentation must specify 'recurrent' pneumonia.
Applicable To
- History of recurrent pneumonia
Excludes
- Current pneumonia (J12-J18)
Clinical Validation Requirements
- Documented history of two or more pneumonia episodes
- Past imaging reports confirming pneumonia
Code-Specific Risks
- Incorrectly using as a principal diagnosis
- Failure to document recurrence
Coding Notes
- Ensure documentation specifies 'recurrent' to use Z87.01.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Follow-up examination after treatment for conditions other than malignant neoplasm
Z09Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Pneumonia, unspecified organism
J18.9Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Personal History of Pneumonia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z87.01.
Impact
Clinical: Inaccurate patient history., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Train staff on documentation requirements., Use templates to ensure completeness.
Impact
Reimbursement: Incorrect sequencing can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient history records.
Mitigation Strategy
Use Z87.01 as a secondary code with a primary code for the current condition.
Impact
Using Z87.01 as a primary diagnosis.
Mitigation Strategy
Educate coders on proper sequencing rules.
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 Pneumonia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Personal History of Pneumonia
Use these documentation templates to ensure complete and accurate documentation for Personal History of Pneumonia. These templates include all required elements for proper coding and billing.
Follow-up visit after pneumonia treatment
Specialty: PulmonologyRequired Elements
- Document recurrence of pneumonia
- Include dates of past episodes
- Include imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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