ICD-10 Coding for Acute Chest Syndrome(D57.01, D57.211)
Complete ICD-10-CM coding and documentation guide for Acute Chest Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Acute Chest Syndrome
D57.0-D57.8Primary Range
Sickle-cell disorders
This range includes all sickle-cell disorders, with specific codes for acute chest syndrome in different genotypes.
Other acute lower respiratory infections
This range includes codes for pneumonia and other respiratory infections, which may be considered in differential diagnosis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D57.01 | Hb-SS disease with acute chest syndrome | Use when a patient with Hb-SS disease presents with a new pulmonary infiltrate and symptoms like chest pain or hypoxia. |
|
| D57.211 | Sickle-cell/HB-C disease with ACS | Use when a patient with HbSC disease presents with a new pulmonary infiltrate and symptoms like chest pain or hypoxia. |
|
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 acute chest syndrome
Essential facts and insights about Acute Chest Syndrome
Primary ICD-10-CM Codes for acute chest syndrome
Decision Criteria
clinical Criteria
- Presence of new infiltrate and symptoms in a sickle-cell patient
Applicable To
- Sickle-cell anemia with acute chest syndrome
Excludes
- Pneumonia (J18.9)
Clinical Validation Requirements
- New pulmonary infiltrate on chest X-ray
- Symptoms such as chest pain, fever, hypoxia
Code-Specific Risks
- Misclassification if pneumonia is present without ACS criteria
Coding Notes
- Ensure documentation specifies the type of sickle-cell disease and confirms ACS criteria.
D57.211 - Sickle-cell/HB-C disease with ACS
Use when a patient with HbSC disease presents with a new pulmonary infiltrate and symptoms like chest pain or hypoxia.
Applicable To
- Sickle-cell/HB-C disease with acute chest syndrome
Excludes
- Pneumonia (J18.9)
Clinical Validation Requirements
- New pulmonary infiltrate on chest X-ray
- Symptoms such as chest pain, fever, hypoxia
Coding Notes
Ensure documentation specifies the type of sickle-cell disease and confirms ACS criteria.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Hypoxemia
R09.02Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Pneumonia, unspecified
J18.9Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Acute Chest Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D57.01.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Could result in audit findings., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Always document the specific sickle-cell genotype., Ensure imaging and symptom details are included.
Impact
Reimbursement: May result in lower reimbursement if ACS is not coded correctly., Compliance: Could lead to compliance issues during audits., Data Quality: Affects the accuracy of clinical data and patient records.
Mitigation Strategy
Ensure documentation supports the specific ACS code by confirming the presence of a new infiltrate and symptoms.
Impact
Inadequate documentation of imaging and symptoms can lead to audit issues.
Mitigation Strategy
Ensure comprehensive documentation of all ACS criteria.
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 Acute Chest Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Acute Chest Syndrome
Use these documentation templates to ensure complete and accurate documentation for Acute Chest Syndrome. These templates include all required elements for proper coding and billing.
Emergency Department Presentation
Specialty: Emergency MedicineRequired Elements
- Sickle-cell genotype
- Symptoms (e.g., chest pain, hypoxia)
- Imaging findings
- Oxygen requirements
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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