ICD-10 Coding for Polycystic Ovarian Syndrome(E28.2)
Complete ICD-10-CM coding and documentation guide for Polycystic Ovarian Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Polycystic Ovarian Syndrome
E28-E28.2Primary Range
Ovarian dysfunction
This range includes codes for ovarian dysfunction, with E28.2 specifically for PCOS.
Key Information: ICD-10 code for polycystic ovarian syndrome
Essential facts and insights about Polycystic Ovarian Syndrome
Primary ICD-10-CM Code for polycystic ovarian syndrome
Decision Criteria
clinical Criteria
- Presence of two out of three Rotterdam criteria.
documentation Criteria
- Detailed menstrual history and laboratory findings.
Applicable To
- Polycystic ovarian disease
- Stein-Leventhal syndrome
Clinical Validation Requirements
- Rotterdam criteria: two of three - androgen excess, ovulatory dysfunction, polycystic ovaries
- Elevated testosterone levels
- Ultrasound showing ≥12 follicles per ovary
Code-Specific Risks
- Coding based solely on ultrasound findings without clinical correlation.
Coding Notes
- Ensure documentation supports the use of E28.2 by meeting clinical criteria.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 Polycystic Ovarian Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E28.2.
Impact
Clinical: Misdiagnosis risk., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Use structured templates for documentation., Ensure all clinical criteria are documented.
Impact
Reimbursement: Potential claim denials due to insufficient documentation., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure clinical criteria are met and documented.
Impact
Lack of detailed documentation supporting the diagnosis of PCOS.
Mitigation Strategy
Use structured templates and ensure all criteria are documented.
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 Polycystic Ovarian Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Polycystic Ovarian Syndrome
Use these documentation templates to ensure complete and accurate documentation for Polycystic Ovarian Syndrome. These templates include all required elements for proper coding and billing.
Endocrinology Progress Note
Specialty: EndocrinologyRequired Elements
- Patient history
- Clinical symptoms
- Laboratory results
- Imaging findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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