ICD-10 Coding for Phimosis(N47.1, N47.0)
Complete ICD-10-CM coding and documentation guide for Phimosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Phimosis
N47-N48Primary Range
Disorders of the prepuce
This range includes all ICD-10 codes related to disorders of the prepuce, including phimosis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N47.1 | Phimosis | Use for pathological phimosis with scarring or BXO. |
|
| N47.0 | Adherent prepuce, newborn | Use for physiological phimosis in infants without scarring. |
|
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 phimosis
Essential facts and insights about Phimosis
Primary ICD-10-CM Codes for phimosis
Decision Criteria
clinical Criteria
- Presence of scarring or BXO confirmed by biopsy
documentation Criteria
- Detailed description of foreskin condition and any associated symptoms
Applicable To
- Pathological phimosis
- Phimosis with scarring
Clinical Validation Requirements
- Documented scarring or fibrosis
- BXO confirmed by biopsy
Code-Specific Risks
- Incorrectly coding physiological phimosis as N47.1
Coding Notes
- Ensure documentation specifies scarring or BXO for accurate coding.
N47.0 - Adherent prepuce, newborn
Use for physiological phimosis in infants without scarring.
Applicable To
- Physiological phimosis in infants
Excludes
- Pathological phimosis (N47.1)
Clinical Validation Requirements
- Age <5 years
- No scarring present
Coding Notes
Ensure age and absence of scarring are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Balanoposthitis
N47.6Differential 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 Phimosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N47.1.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Use specific terms like 'scarring' or 'fibrosis'., Document associated symptoms and findings.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Use N47.0 for physiological phimosis in infants.
Impact
Using N47.1 for physiological phimosis can trigger audits.
Mitigation Strategy
Ensure accurate documentation of phimosis type.
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 Phimosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Phimosis
Use these documentation templates to ensure complete and accurate documentation for Phimosis. These templates include all required elements for proper coding and billing.
Adult with pathological phimosis
Specialty: UrologyRequired Elements
- History of foreskin issues
- Physical exam findings
- Biopsy results if applicable
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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