ICD-10 Coding for Atypical Lobular Hyperplasia(N60.89)
Complete ICD-10-CM coding and documentation guide for Atypical Lobular Hyperplasia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Atypical Lobular Hyperplasia
N60-N64Primary Range
Benign mammary dysplasias
This range includes codes for benign breast conditions, under which atypical lobular hyperplasia is classified.
Key Information: ICD-10 code for atypical lobular hyperplasia
Essential facts and insights about Atypical Lobular Hyperplasia
Primary ICD-10-CM Code for atypical lobular hyperplasia
Decision Criteria
clinical Criteria
- Biopsy confirms atypical lobular hyperplasia without evidence of malignancy.
documentation Criteria
- Pathology report must explicitly state 'atypical lobular hyperplasia'.
Applicable To
- Atypical lobular hyperplasia
Excludes
- Lobular carcinoma in situ (D05.92)
Clinical Validation Requirements
- Pathology report confirming atypical lobular hyperplasia
- Biopsy results showing E-cadherin loss
Code-Specific Risks
- Confusion with lobular carcinoma in situ, leading to incorrect coding.
Coding Notes
- Ensure documentation specifies 'atypical lobular hyperplasia' to avoid confusion with malignant conditions.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for screening mammogram for malignant neoplasm of breast
Z12.31Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Atypical Lobular Hyperplasia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N60.89.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Could result in coding audits and penalties., Financial: Incorrect coding affects reimbursement accuracy.
Mitigation Strategy
Ensure clear documentation of the specific condition., Educate providers on the importance of precise terminology.
Impact
Reimbursement: Incorrect coding may lead to inappropriate reimbursement rates., Compliance: May result in compliance issues due to misrepresentation of the patient's condition., Data Quality: Affects the accuracy of patient records and clinical data.
Mitigation Strategy
Ensure biopsy confirms ALH without malignancy before coding.
Impact
Risk of coding benign conditions as malignant.
Mitigation Strategy
Implement regular training for coders on differentiating benign and malignant breast conditions.
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 Atypical Lobular Hyperplasia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Atypical Lobular Hyperplasia
Use these documentation templates to ensure complete and accurate documentation for Atypical Lobular Hyperplasia. These templates include all required elements for proper coding and billing.
Breast Surgery Follow-Up
Specialty: Surgical OncologyRequired Elements
- Diagnosis of atypical lobular hyperplasia
- Biopsy results
- Screening recommendations
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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