ICD-10 Coding for Personal History of Pulmonary Embolism(Z86.711)
Complete ICD-10-CM coding and documentation guide for Personal History of Pulmonary Embolism. 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 Pulmonary Embolism
Z86.71-Z86.79Primary Range
Personal history of diseases of the circulatory system
This range includes codes for personal history of circulatory system diseases, including pulmonary embolism.
Key Information: ICD-10 code for personal history of pulmonary embolism
Essential facts and insights about Personal History of Pulmonary Embolism
Primary ICD-10-CM Code for personal history of pulmonary embolism
Decision Criteria
clinical Criteria
- Negative imaging and no current symptoms
documentation Criteria
- Explicit statement of resolved PE
Applicable To
- Resolved pulmonary embolism
Excludes
- Current pulmonary embolism (I26.99)
Clinical Validation Requirements
- Negative imaging (CT/VQ scan) for current PE
- Normalized D-dimer levels
- No anticoagulation for more than 3 months
Code-Specific Risks
- Confusing history codes with current condition codes
Coding Notes
- Ensure documentation clearly states the PE is resolved and not current.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long-term (current) use of anticoagulants
Z79.01Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Acute pulmonary embolism
I26.xxDocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Personal History of Pulmonary Embolism to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z86.711.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Could result in audit findings., Financial: Potential for denied claims.
Mitigation Strategy
Always include imaging results, State resolution explicitly
Impact
Reimbursement: Incorrect coding can lead to improper DRG assignment., Compliance: May trigger audits due to coding discrepancies., Data Quality: Affects accuracy of patient history records.
Mitigation Strategy
Verify resolution status and use Z86.711 for historical cases.
Impact
Using acute codes for historical conditions.
Mitigation Strategy
Regular training on code differentiation.
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 Pulmonary Embolism, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Personal History of Pulmonary Embolism
Use these documentation templates to ensure complete and accurate documentation for Personal History of Pulmonary Embolism. These templates include all required elements for proper coding and billing.
Follow-up visit for resolved PE
Specialty: Primary CareRequired Elements
- Patient history of PE
- Current anticoagulation status
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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