ICD-10 Coding for Alport Syndrome(Q87.81)
Complete ICD-10-CM coding and documentation guide for Alport Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Alport Syndrome
Q87.81Primary Range
Congenital malformation syndromes predominantly associated with short stature
Primary code for Alport syndrome, used when diagnosis is confirmed.
Nephrotic syndrome and other glomerular disorders
Used for documenting nephrotic syndrome and related kidney issues in Alport syndrome.
Other disorders of lens
Used for documenting ocular manifestations like anterior lenticonus in Alport syndrome.
Key Information: ICD-10 code for Alport syndrome
Essential facts and insights about Alport Syndrome
Primary ICD-10-CM Code for alport syndrome
Decision Criteria
clinical Criteria
- Presence of genetic mutation in COL4A3, COL4A4, or COL4A5.
documentation Criteria
- Documented family history and clinical symptoms consistent with Alport syndrome.
Applicable To
- Alport syndrome with confirmed genetic mutation
Excludes
- Other specified congenital malformations
Clinical Validation Requirements
- Genetic test results showing COL4A3, COL4A4, or COL4A5 variants
- Family history of Alport syndrome
- Renal biopsy findings
Code-Specific Risks
- Risk of audit if used without supporting genetic or biopsy documentation.
Coding Notes
- Ensure genetic confirmation or clinical criteria are documented to support coding.
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.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Alport Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Q87.81.
Impact
Clinical: May lead to incomplete clinical picture., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials for incomplete documentation.
Mitigation Strategy
Ensure audiometry results are included in the patient record., Verify documentation before coding.
Impact
Reimbursement: May lead to denied claims due to lack of specificity., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Decreases accuracy of health records.
Mitigation Strategy
Specify 'Alport syndrome' and include genetic testing results.
Impact
Risk of audit if genetic testing is not documented when coding for Alport syndrome.
Mitigation Strategy
Ensure all genetic testing results are included in the patient's medical record.
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 Alport Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Alport Syndrome
Use these documentation templates to ensure complete and accurate documentation for Alport Syndrome. These templates include all required elements for proper coding and billing.
Nephrology Progress Note
Specialty: NephrologyRequired Elements
- Family history of Alport syndrome
- Genetic test results
- Renal biopsy findings
- Audiometry results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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