ICD-10 Coding for Amyotrophic Lateral Sclerosis(G12.21)
Complete ICD-10-CM coding and documentation guide for Amyotrophic Lateral Sclerosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Amyotrophic Lateral Sclerosis
G12.21Primary Range
ICD-10 code for Amyotrophic Lateral Sclerosis
Primary code for diagnosing ALS, covering both upper and lower motor neuron involvement.
ICD-10 codes for other motor neuron diseases
Differential diagnoses for ALS, including primary lateral sclerosis and progressive muscular atrophy.
Key Information: ICD-10 code for amyotrophic lateral sclerosis
Essential facts and insights about Amyotrophic Lateral Sclerosis
Primary ICD-10-CM Code for amyotrophic lateral sclerosis
Decision Criteria
clinical Criteria
- Presence of both upper and lower motor neuron signs in multiple regions.
documentation Criteria
- Detailed documentation of symptom progression and exclusion of other conditions.
Clinical Validation Requirements
- Upper and lower motor neuron signs in multiple regions
- EMG showing acute and chronic denervation
- Exclusion of other conditions like myelopathy
Code-Specific Risks
- Undercoding if only general motor neuron disease is documented
- Overcoding if criteria for ALS are not fully met
Coding Notes
- Ensure documentation includes both UMN and LMN signs to support ALS diagnosis.
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 Amyotrophic Lateral Sclerosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G12.21.
Impact
Clinical: Misdiagnosis or delayed diagnosis of ALS., Regulatory: Non-compliance with documentation standards., Financial: Potential denial of claims due to insufficient documentation.
Mitigation Strategy
Ensure detailed clinical notes are taken, Use specific terminology for UMN and LMN signs
Impact
Reimbursement: Potential underpayment due to incorrect coding., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure documentation supports ALS-specific criteria, including both UMN and LMN signs.
Impact
Risk of audits due to insufficient clinical documentation supporting ALS diagnosis.
Mitigation Strategy
Ensure comprehensive documentation of clinical findings and diagnostic tests.
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 Amyotrophic Lateral Sclerosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Amyotrophic Lateral Sclerosis
Use these documentation templates to ensure complete and accurate documentation for Amyotrophic Lateral Sclerosis. These templates include all required elements for proper coding and billing.
ALS diagnosis and management
Specialty: NeurologyRequired Elements
- Patient history
- Neurological examination findings
- EMG results
- Genetic testing
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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