ICD-10 Coding for Klebsiella pneumoniae pneumonia(J15.0, B96.1)
Complete ICD-10-CM coding and documentation guide for Klebsiella pneumoniae pneumonia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Klebsiella pneumoniae pneumonia
J12-J18Primary Range
Pneumonia due to specific organisms
This range includes specific codes for pneumonia caused by various organisms, including Klebsiella pneumoniae.
Bacterial and viral infectious agents
This range includes codes for identifying infectious agents causing diseases classified elsewhere, such as Klebsiella pneumoniae.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| J15.0 | Pneumonia due to Klebsiella pneumoniae | Use when pneumonia is confirmed to be caused by Klebsiella pneumoniae. |
|
| B96.1 | Klebsiella pneumoniae as the cause of diseases classified elsewhere | Use as a secondary code when Klebsiella pneumoniae is the identified cause of a condition other than pneumonia. |
|
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 Klebsiella pneumoniae pneumonia
Essential facts and insights about Klebsiella pneumoniae pneumonia
Primary ICD-10-CM Codes for thousand pneumoniae
Decision Criteria
clinical Criteria
- Presence of lobar consolidation and positive culture for Klebsiella pneumoniae
Applicable To
- Lobar pneumonia due to Klebsiella
Excludes
- Pneumonia due to other specified bacteria (J15.8)
Clinical Validation Requirements
- Sputum or PCR confirmation of Klebsiella pneumoniae
- Imaging showing lobar consolidation
Code-Specific Risks
- Incorrectly using this code without laboratory confirmation
Coding Notes
- Ensure laboratory confirmation of Klebsiella pneumoniae before using this code.
B96.1 - Klebsiella pneumoniae as the cause of diseases classified elsewhere
Use as a secondary code when Klebsiella pneumoniae is the identified cause of a condition other than pneumonia.
Clinical Validation Requirements
- Positive identification of Klebsiella pneumoniae in cultures related to the condition
Coding Notes
This code should never be used as a primary diagnosis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Klebsiella pneumoniae as the cause of diseases classified elsewhere
B96.1Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Other specified bacterial pneumonia
J15.8Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Klebsiella pneumoniae pneumonia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code J15.0.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with ICD-10 guidelines., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Ensure laboratory confirmation of the causative organism., Document organism in the patient's medical record.
Impact
Reimbursement: Incorrect sequencing can lead to denied claims., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate data on infectious disease prevalence.
Mitigation Strategy
Always use B96.1 as a secondary code with the primary condition code.
Impact
Using B96.1 as a primary code instead of secondary.
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 Klebsiella pneumoniae pneumonia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Klebsiella pneumoniae pneumonia
Use these documentation templates to ensure complete and accurate documentation for Klebsiella pneumoniae pneumonia. These templates include all required elements for proper coding and billing.
Hospital-acquired pneumonia due to Klebsiella pneumoniae
Specialty: PulmonologyRequired Elements
- Patient history
- Laboratory results
- Imaging findings
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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