ICD-10 Coding for Rapid Plasma Reagin Test(A53.9, R76.8)
Complete ICD-10-CM coding and documentation guide for Rapid Plasma Reagin Test. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Rapid Plasma Reagin Test
A50-A64Primary Range
Infections with a predominantly sexual mode of transmission
This range includes syphilis and other sexually transmitted infections, which are relevant for RPR testing.
Abnormal findings on examination of blood, without diagnosis
This range includes codes for abnormal serological findings, such as false-positive RPR results.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A53.9 | Syphilis, unspecified | Use when RPR is reactive and confirmed by a positive treponemal test. |
|
| R76.8 | Other specified abnormal immunological findings in serum | Use when RPR is reactive but confirmatory tests are negative. |
|
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 reactive RPR test
Essential facts and insights about Rapid Plasma Reagin Test
Primary ICD-10-CM Codes for rapid plasma reagin test
Decision Criteria
clinical Criteria
- Reactive RPR with positive treponemal test
Applicable To
- Confirmed syphilis with reactive RPR and positive treponemal test
Excludes
- Congenital syphilis (A50.-)
Clinical Validation Requirements
- Reactive RPR with confirmatory positive treponemal test
Code-Specific Risks
- Misclassification if confirmatory test is not documented
Coding Notes
- Ensure confirmatory testing is documented to support the use of this code.
R76.8 - Other specified abnormal immunological findings in serum
Use when RPR is reactive but confirmatory tests are negative.
Applicable To
- False-positive RPR results
Excludes
- Confirmed syphilis (A53.9)
Clinical Validation Requirements
- Reactive RPR with negative confirmatory treponemal test
Coding Notes
Document the cause of the false-positive result if known.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other viral agents as the cause of diseases classified elsewhere
B97.89Differential 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 Rapid Plasma Reagin Test to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A53.9.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials due to insufficient documentation.
Mitigation Strategy
Use specific language such as 'Reactive RPR with titer 1:16 confirmed by FTA-ABS.'
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Ensure confirmatory tests are documented and use A53.9 for confirmed cases.
Impact
Misclassification of syphilis status due to incorrect code selection.
Mitigation Strategy
Ensure confirmatory test results are documented and codes are selected accordingly.
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 Rapid Plasma Reagin Test, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Rapid Plasma Reagin Test
Use these documentation templates to ensure complete and accurate documentation for Rapid Plasma Reagin Test. These templates include all required elements for proper coding and billing.
Reactive RPR with Confirmatory Testing
Specialty: Infectious DiseaseRequired Elements
- Patient history
- RPR titer result
- Confirmatory test result
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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