ICD-10 Coding for Atrioventricular Fistula Malfunction(T82.5, I97.8, I72.1)
Complete ICD-10-CM coding and documentation guide for Atrioventricular Fistula Malfunction. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Atrioventricular Fistula Malfunction
T82.5-T82.8Primary Range
Complications of cardiac and vascular prosthetic devices, implants and grafts
This range includes codes for mechanical complications of AV fistulas, such as stenosis and thrombosis.
Other postprocedural disorders of the circulatory system, not elsewhere classified
Used for postprocedural circulatory disorders without specific mechanical complications.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| T82.5 | Mechanical complication of cardiac and vascular devices and implants | Use when there is a documented mechanical complication of the AV fistula. |
|
| I97.8 | Other postprocedural disorders of the circulatory system, not elsewhere classified | Use when there is a postprocedural circulatory disorder without a mechanical complication. |
|
| I72.1 | Aneurysm of artery of upper extremity | Use when an aneurysm is documented at the fistula site. |
|
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 AV fistula malfunction
Essential facts and insights about Atrioventricular Fistula Malfunction
Primary ICD-10-CM Codes for atrioventricular fistula malfunction
Decision Criteria
clinical Criteria
- Presence of mechanical complication confirmed by imaging
Applicable To
- Stenosis of AV fistula
- Thrombosis of AV fistula
Excludes
- Infection of AV fistula
Clinical Validation Requirements
- Doppler ultrasound showing stenosis
- Angiography confirming thrombosis
Code-Specific Risks
- Misclassification if the complication is not mechanical
Coding Notes
- Ensure documentation specifies the mechanical nature of the complication.
I97.8 - Other postprocedural disorders of the circulatory system, not elsewhere classified
Use when there is a postprocedural circulatory disorder without a mechanical complication.
Applicable To
- Vascular steal syndrome
Excludes
- Mechanical complications of AV fistula
Clinical Validation Requirements
- Clinical documentation of vascular steal syndrome without mechanical issues
Coding Notes
Ensure no mechanical complication is documented.
I72.1 - Aneurysm of artery of upper extremity
Use when an aneurysm is documented at the fistula site.
Applicable To
- Pseudoaneurysm at AV fistula site
Clinical Validation Requirements
- Imaging showing aneurysm formation
Coding Notes
Ensure aneurysm is confirmed by imaging.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Embolism and thrombosis of other specified veins
I82.8Differential 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 Atrioventricular Fistula Malfunction to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code T82.5.
Impact
Clinical: Leads to misdiagnosis and inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Use specific medical terminology., Ensure thorough clinical assessment.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Use T82.5 for mechanical complications and I97.8 only for non-mechanical postprocedural disorders.
Impact
Failure to sequence mechanical complication codes first.
Mitigation Strategy
Educate coding staff on proper sequencing rules.
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 Atrioventricular Fistula Malfunction, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Atrioventricular Fistula Malfunction
Use these documentation templates to ensure complete and accurate documentation for Atrioventricular Fistula Malfunction. These templates include all required elements for proper coding and billing.
AV Fistula Stenosis
Specialty: NephrologyRequired Elements
- Location of stenosis
- Degree of narrowing
- Impact on dialysis
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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