ICD-10 Coding for Pickwickian Syndrome(E66.2, G47.33)
Complete ICD-10-CM coding and documentation guide for Pickwickian Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pickwickian Syndrome
E66-E66.9Primary Range
Obesity codes, including morbid obesity with alveolar hypoventilation
This range includes the primary code for Pickwickian syndrome, E66.2.
Sleep disorders, including obstructive sleep apnea
This range includes G47.33, which is used if OSA is present without hypoventilation.
Body mass index (BMI) codes
BMI codes are necessary to specify the obesity class in Pickwickian syndrome.
Respiratory failure codes
Used if respiratory failure is present alongside Pickwickian syndrome.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E66.2 | Morbid (severe) obesity with alveolar hypoventilation | Use when obesity is linked to alveolar hypoventilation and sleep-disordered breathing. |
|
| G47.33 | Obstructive sleep apnea | Use when OSA is present without obesity-related hypoventilation. |
|
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 Pickwickian syndrome
Essential facts and insights about Pickwickian Syndrome
Primary ICD-10-CM Codes for pickwickian syndrome
Decision Criteria
clinical Criteria
- Presence of daytime hypercapnia and obesity.
coding Criteria
- Do not code G47.33 if E66.2 criteria are met.
documentation Criteria
- Document BMI and link to hypoventilation.
Applicable To
- Obesity hypoventilation syndrome
- Pickwickian syndrome
Excludes
- Obstructive sleep apnea (G47.33)
Clinical Validation Requirements
- BMI ≥30
- Daytime hypercapnia (pCO2 >45 mmHg)
- Sleep-disordered breathing
Code-Specific Risks
- Incorrectly coding OSA separately when hypoventilation is present.
Coding Notes
- Ensure documentation explicitly links obesity to hypoventilation and includes BMI.
G47.33 - Obstructive sleep apnea
Use when OSA is present without obesity-related hypoventilation.
Excludes
- Obesity hypoventilation syndrome (E66.2)
Clinical Validation Requirements
- Polysomnography confirming OSA
- Absence of daytime hypercapnia
Coding Notes
Ensure documentation supports absence of hypoventilation.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Pickwickian Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E66.2.
Impact
Clinical: May lead to incorrect treatment focus., Regulatory: Non-compliance with coding guidelines., Financial: Potential loss of reimbursement.
Mitigation Strategy
Educate providers on documentation requirements., Use templates that prompt for necessary details.
Impact
Reimbursement: Incorrect coding may lead to reduced reimbursement., Compliance: Violates Excludes1 note, risking compliance issues., Data Quality: Compromises data accuracy and quality.
Mitigation Strategy
Use only E66.2 if hypoventilation is present.
Impact
Reimbursement: May affect reimbursement accuracy., Compliance: Incomplete coding documentation., Data Quality: Inaccurate representation of patient's condition.
Mitigation Strategy
Always include the appropriate BMI code (Z68.3- or Z68.4-).
Impact
Coding both E66.2 and G47.33 together when hypoventilation is present.
Mitigation Strategy
Educate coders on Excludes1 note and proper code selection.
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 Pickwickian Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pickwickian Syndrome
Use these documentation templates to ensure complete and accurate documentation for Pickwickian Syndrome. These templates include all required elements for proper coding and billing.
Pulmonology Progress Note
Specialty: PulmonologyRequired Elements
- BMI documentation
- ABG results
- Polysomnography findings
- Exclusion of other causes
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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