ICD-10 Coding for Acute Pericarditis(I30.0, I30.1, I30.9)
Complete ICD-10-CM coding and documentation guide for Acute Pericarditis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Acute Pericarditis
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I30.0 | Acute nonspecific idiopathic pericarditis | Use when no specific cause is identified after workup. |
|
| I30.1 | Infective pericarditis | Use when an infectious agent is identified. |
|
| I30.9 | Acute pericarditis, unspecified | Use when specific etiology is not documented. |
|
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 pericarditis
Essential facts and insights about Acute Pericarditis
Primary ICD-10-CM Codes for acute pericarditis
Decision Criteria
clinical Criteria
- No identifiable cause despite thorough investigation.
Applicable To
- Idiopathic pericarditis
Excludes
- Chronic pericarditis (I31.3)
Clinical Validation Requirements
- Sudden onset chest pain
- ECG changes
- Pericardial rub
- Pericardial effusion
Code-Specific Risks
- Misclassification if etiology is later identified.
Coding Notes
- Ensure idiopathic nature is documented.
I30.1 - Infective pericarditis
Use when an infectious agent is identified.
Applicable To
- Bacterial pericarditis
- Viral pericarditis
Excludes
- Tuberculous pericarditis (A18.84)
Clinical Validation Requirements
- Positive culture or PCR for infectious agent
- Symptoms of infection
Coding Notes
Ensure documentation of the infectious agent.
I30.9 - Acute pericarditis, unspecified
Use when specific etiology is not documented.
Applicable To
- Acute pericarditis NOS
Excludes
- Chronic pericarditis (I31.3)
Clinical Validation Requirements
- Acute chest pain
- ECG changes
- Pericardial effusion
Coding Notes
Ensure acute nature is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Streptococcus, group A, as the cause of diseases classified elsewhere
B95.6Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Acute Pericarditis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I30.0.
Impact
Clinical: May lead to misdiagnosis or delayed treatment., Regulatory: Fails to meet coding standards for specificity., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Use specific descriptors for pain, Document associated symptoms
Impact
Reimbursement: Incorrect DRG assignment leading to reimbursement issues., Compliance: Potential for audit findings due to incorrect coding., Data Quality: Inaccurate clinical data affecting patient care.
Mitigation Strategy
Ensure documentation clearly states 'acute' or 'chronic'.
Impact
Reimbursement: Incomplete coding may affect case severity and reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate representation of patient condition.
Mitigation Strategy
Always add B95-B97 codes for the infectious agent.
Impact
Risk of coding acute pericarditis as chronic or vice versa.
Mitigation Strategy
Implement thorough review of clinical documentation for symptom duration and characteristics.
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 Pericarditis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Acute Pericarditis
Use these documentation templates to ensure complete and accurate documentation for Acute Pericarditis. These templates include all required elements for proper coding and billing.
Acute pericarditis in emergency setting
Specialty: Emergency MedicineRequired Elements
- Onset and character of chest pain
- ECG findings
- Physical exam findings
- Laboratory results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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