ICD-10 Coding for Stevens-Johnson Syndrome(L51.1, T36-T50.XX5A)
Complete ICD-10-CM coding and documentation guide for Stevens-Johnson Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Stevens-Johnson Syndrome
L51-L51.9Primary Range
Erythema multiforme and related conditions
This range includes Stevens-Johnson syndrome and its variants, such as SJS-TEN overlap.
Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances
This range is used for coding adverse drug reactions that can cause SJS.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| L51.1 | Stevens-Johnson syndrome | Use when SJS is diagnosed without TEN overlap and meets clinical criteria. |
|
| T36-T50.XX5A | Adverse effect of drugs, medicaments and biological substances | Use as first-listed code when SJS is drug-induced. |
|
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 Stevens-Johnson syndrome
Essential facts and insights about Stevens-Johnson Syndrome
Primary ICD-10-CM Codes for steven johnson syndrome
Decision Criteria
clinical Criteria
- Presence of <10% BSA detachment and mucosal involvement
Applicable To
- SJS without TEN overlap
Excludes
- Toxic epidermal necrolysis (L51.2)
Clinical Validation Requirements
- Detachable epidermis involving <10% BSA
- Involvement of at least two mucosal sites
Code-Specific Risks
- Incorrectly coding without drug etiology when applicable
Coding Notes
- Ensure drug causality is documented if applicable.
T36-T50.XX5A - Adverse effect of drugs, medicaments and biological substances
Use as first-listed code when SJS is drug-induced.
Applicable To
- Adverse drug reactions causing SJS
Clinical Validation Requirements
- Temporal association with drug initiation
Coding Notes
Ensure drug name and initiation date are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Keratoconjunctivitis
H16.2-Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Stevens-Johnson syndrome-Toxic epidermal necrolysis overlap syndrome
L51.3Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Stevens-Johnson Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code L51.1.
Impact
Clinical: May lead to misdiagnosis or incorrect treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Use specific descriptors for skin and mucosal involvement, Include drug causality when applicable
Impact
Reimbursement: Incorrect sequencing can lead to reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on drug-induced conditions.
Mitigation Strategy
Always query for drug causality and sequence T code first.
Impact
Failure to document drug causality can lead to audit issues.
Mitigation Strategy
Ensure all drug-related information is clearly 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 Stevens-Johnson Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Stevens-Johnson Syndrome
Use these documentation templates to ensure complete and accurate documentation for Stevens-Johnson Syndrome. These templates include all required elements for proper coding and billing.
Acute SJS presentation
Specialty: DermatologyRequired Elements
- BSA involvement
- Mucosal site involvement
- Drug causality
- Biopsy results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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