ICD-10 Coding for STEC Gastroenteritis(A04.3, B96.22)
Complete ICD-10-CM coding and documentation guide for STEC Gastroenteritis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to STEC Gastroenteritis
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A04.3 | Enterohemorrhagic Escherichia coli infection | Use when STEC infection is confirmed by laboratory tests. |
|
| B96.22 | Escherichia coli [E. coli] as the cause of diseases classified elsewhere | Use as an additional code to specify STEC as the causative agent. |
|
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 STEC gastroenteritis
Essential facts and insights about STEC Gastroenteritis
Primary ICD-10-CM Codes for stec gastroenteritis
Decision Criteria
clinical Criteria
- Confirmed STEC infection via lab tests
coding Criteria
- Use A04.3 for primary coding of STEC gastroenteritis
Applicable To
- STEC gastroenteritis
- E. coli O157:H7 infection
Excludes
- Non-STEC E. coli infections
Clinical Validation Requirements
- Stool PCR positive for stx1/stx2 and eae genes
- Culture confirms STEC O157:H7 or other serotypes
Code-Specific Risks
- Misclassification if lab results are not specific to STEC.
Coding Notes
- Ensure lab confirmation of STEC before coding.
B96.22 - Escherichia coli [E. coli] as the cause of diseases classified elsewhere
Use as an additional code to specify STEC as the causative agent.
Applicable To
- STEC as a causative agent
Excludes
- Non-STEC E. coli infections
Clinical Validation Requirements
- Lab confirmation of STEC presence
Coding Notes
Ensure B96.22 follows a primary code indicating the condition.
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.
Enterotoxigenic Escherichia coli infection
A04.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting STEC Gastroenteritis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A04.3.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Specify STEC in documentation, Include lab confirmation details
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on disease prevalence.
Mitigation Strategy
Always pair B96.22 with a primary code like A04.3.
Impact
Using B96.22 without a primary code like A04.3.
Mitigation Strategy
Educate coders on proper sequencing rules.
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 STEC Gastroenteritis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for STEC Gastroenteritis
Use these documentation templates to ensure complete and accurate documentation for STEC Gastroenteritis. These templates include all required elements for proper coding and billing.
Emergency Department Visit
Specialty: Emergency MedicineRequired Elements
- Patient history
- Symptoms onset and duration
- Lab test results
- Exposure history
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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