ICD-10 Coding for Balanitis(B37.42, N48.1, N47.6)
Complete ICD-10-CM coding and documentation guide for Balanitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Balanitis
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| B37.42 | Candidal balanitis | Use when Candida infection is confirmed by lab tests. |
|
| N48.1 | Balanitis, unspecified | Use when balanitis is diagnosed without a specific pathogen. |
|
| N47.6 | Balanoposthitis | Use when both the glans and foreskin are inflamed. |
|
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 candidal balanitis
Essential facts and insights about Balanitis
Primary ICD-10-CM Codes for balanitis
Decision Criteria
clinical Criteria
- Confirmed Candida infection via lab tests
Applicable To
- Candidal infection of the glans
Excludes
- Balanitis due to other specified organisms
Clinical Validation Requirements
- KOH prep or fungal culture confirming Candida
- Presence of yeast-like organisms on microscopy
Code-Specific Risks
- Incorrect use without lab confirmation of Candida
Coding Notes
- Ensure lab confirmation of Candida before using this code.
N48.1 - Balanitis, unspecified
Use when balanitis is diagnosed without a specific pathogen.
Applicable To
- Non-specific inflammation of the glans
Excludes
- Candidal balanitis (B37.42)
Clinical Validation Requirements
- Documentation of erythema and swelling without identified pathogen
Coding Notes
Ensure no specific pathogen is documented before using this code.
N47.6 - Balanoposthitis
Use when both the glans and foreskin are inflamed.
Applicable To
- Inflammation of both glans and foreskin
Excludes
- Balanitis without foreskin involvement
Clinical Validation Requirements
- Documentation of inflammation of both glans and foreskin
Coding Notes
Ensure documentation specifies inflammation of both glans and foreskin.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Balanitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B37.42.
Impact
Clinical: Leads to inappropriate treatment., Regulatory: Fails to meet documentation standards., Financial: May result in denied claims.
Mitigation Strategy
Provide detailed clinical findings., Include lab results when applicable.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure lab tests confirm Candida before coding.
Impact
Using B37.42 without lab confirmation of Candida.
Mitigation Strategy
Ensure lab results confirm Candida before coding.
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 Balanitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Balanitis
Use these documentation templates to ensure complete and accurate documentation for Balanitis. These templates include all required elements for proper coding and billing.
Candidal balanitis in a diabetic patient
Specialty: UrologyRequired Elements
- Patient history
- Physical examination findings
- Lab test results
- Diagnosis
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Balanitis? Ask your questions below.