ICD-10 Coding for Apixaban Therapy(I48.91, T45.515A, Z79.01)
Complete ICD-10-CM coding and documentation guide for Apixaban Therapy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Apixaban Therapy
I48-I49Primary Range
Atrial fibrillation and flutter
Primary range for conditions treated with apixaban, such as non-valvular atrial fibrillation.
Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances
Includes codes for adverse effects of anticoagulants like apixaban.
Long-term (current) drug therapy
Used for documenting long-term use of anticoagulants such as apixaban.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I48.91 | Unspecified atrial fibrillation | Use for patients with non-valvular atrial fibrillation on apixaban for stroke prevention. |
|
| T45.515A | Adverse effect of anticoagulants, initial encounter | Use when a patient experiences a bleeding complication directly linked to apixaban. |
|
| Z79.01 | Long term (current) use of anticoagulants | Use for patients on long-term apixaban therapy. |
|
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 apixaban
Essential facts and insights about Apixaban Therapy
Primary ICD-10-CM Codes for apixaban
Decision Criteria
clinical Criteria
- Patient has non-valvular atrial fibrillation with CHA₂DS₂-VASc score ≥2.
Applicable To
- Non-valvular atrial fibrillation
Excludes
- Valvular atrial fibrillation
Clinical Validation Requirements
- CHA₂DS₂-VASc score ≥2
- ECG confirming atrial fibrillation
Code-Specific Risks
- Ensure CHA₂DS₂-VASc score is documented.
Coding Notes
- Ensure documentation includes CHA₂DS₂-VASc score and ECG results.
T45.515A - Adverse effect of anticoagulants, initial encounter
Use when a patient experiences a bleeding complication directly linked to apixaban.
Applicable To
- Bleeding complications due to apixaban
Excludes
- Bleeding not related to anticoagulant use
Clinical Validation Requirements
- Documented bleeding event
- INR <2.0
Coding Notes
Ensure adverse effect is clearly documented as related to apixaban.
Z79.01 - Long term (current) use of anticoagulants
Use for patients on long-term apixaban therapy.
Applicable To
- Chronic use of apixaban
Excludes
- Short-term anticoagulant use
Clinical Validation Requirements
- Documentation of ongoing apixaban therapy
Coding Notes
Ensure duration of therapy is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long term (current) use of anticoagulants
Z79.01Differential 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 Apixaban Therapy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I48.91.
Impact
Clinical: Inadequate risk assessment for stroke., Regulatory: Non-compliance with treatment guidelines., Financial: Potential for denied claims.
Mitigation Strategy
Regularly update CHA₂DS₂-VASc score in patient records., Use templates to ensure complete documentation.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate data on anticoagulant use.
Mitigation Strategy
Use Z79.01 for long-term use and T45.515A for adverse effects.
Impact
Inadequate documentation of long-term anticoagulant therapy.
Mitigation Strategy
Use standardized templates to ensure complete documentation.
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 Apixaban Therapy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Apixaban Therapy
Use these documentation templates to ensure complete and accurate documentation for Apixaban Therapy. These templates include all required elements for proper coding and billing.
Atrial Fibrillation Management
Specialty: CardiologyRequired Elements
- CHA₂DS₂-VASc score
- ECG results
- Apixaban dosage
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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