ICD-10 Coding for Behçet's Disease(M35.2)
Complete ICD-10-CM coding and documentation guide for Behçet's Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Behçet's Disease
Disorders of iris and ciliary body
Used for coding ocular manifestations like uveitis associated with Behçet's.
Other disorders of skin and subcutaneous tissue, not elsewhere classified
Used for coding skin manifestations such as ulcers in Behçet's.
Key Information: ICD-10 code for Behçet's disease
Essential facts and insights about Behçet's Disease
Primary ICD-10-CM Code for behcet's disease
Decision Criteria
clinical Criteria
- Presence of recurrent oral ulcers and at least two other major criteria.
documentation Criteria
- Detailed documentation of symptoms and diagnostic tests confirming Behçet's.
Applicable To
- Behçet's syndrome
Excludes
- Recurrent oral aphthae (K12.0)
Clinical Validation Requirements
- Recurrent oral ulcers (≥3 episodes per year)
- Presence of two additional major criteria (e.g., genital ulcers, ocular lesions)
Code-Specific Risks
- Incorrect use without meeting diagnostic criteria can lead to audits.
Coding Notes
- Ensure documentation supports the use of M35.2 by confirming ISG/ICBD criteria.
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.
Recurrent oral aphthae
K12.0Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Behçet's Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M35.2.
Impact
Clinical: Leads to misdiagnosis and inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Ensure criteria are met before coding., Use queries to clarify documentation.
Impact
Reimbursement: Incorrect coding can affect DRG assignment and reimbursement., Compliance: May lead to audits and compliance issues., Data Quality: Impacts accuracy of clinical data and risk adjustment.
Mitigation Strategy
Ensure documentation meets ISG/ICBD criteria before coding.
Impact
Failure to sequence M35.2 before manifestations.
Mitigation Strategy
Educate coders 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 Behçet's Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Behçet's Disease
Use these documentation templates to ensure complete and accurate documentation for Behçet's Disease. These templates include all required elements for proper coding and billing.
Ophthalmology Progress Note
Specialty: OphthalmologyRequired Elements
- Chief complaint
- Ocular findings
- Oral and genital ulcer documentation
- Lab results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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