ICD-10 Coding for C. difficile Unspecified(A04.72, A48.8)
Complete ICD-10-CM coding and documentation guide for C. difficile Unspecified. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to C. difficile Unspecified
A04.7-A04.8Primary Range
Other bacterial intestinal infections
This range includes codes for Clostridium difficile infections, specifically differentiating between recurrent and non-recurrent cases.
Other specified bacterial diseases
Used for non-enterocolitis infections caused by Clostridium difficile, such as bacteremia.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A04.72 | Enterocolitis due to Clostridium difficile, not specified as recurrent | Use when the patient has enterocolitis due to C. difficile and recurrence is not specified. |
|
| A48.8 | Other specified bacterial diseases | Use when C. difficile infection is present without enterocolitis. |
|
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 unspecified C. difficile
Essential facts and insights about C. difficile Unspecified
Primary ICD-10-CM Codes for c difficile unspecified
Decision Criteria
clinical Criteria
- Presence of diarrhea and positive C. difficile test
documentation Criteria
- Absence of 'recurrent' in documentation
Applicable To
- Non-recurrent C. difficile enterocolitis
Excludes
- Recurrent C. difficile enterocolitis (A04.71)
Clinical Validation Requirements
- Positive stool test for C. difficile toxin
- Clinical symptoms such as diarrhea
Code-Specific Risks
- Misclassification if recurrence is not documented
Coding Notes
- Ensure documentation specifies 'not recurrent' if using A04.72.
A48.8 - Other specified bacterial diseases
Use when C. difficile infection is present without enterocolitis.
Applicable To
- C. difficile bacteremia
Excludes
- Enterocolitis due to C. difficile (A04.7x)
Clinical Validation Requirements
- Positive blood culture for C. difficile
Coding Notes
Ensure the infection type is clearly documented as non-enterocolitis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Toxic gastroenteritis and colitis
K52.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting C. difficile Unspecified to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A04.72.
Impact
Clinical: Leads to misdiagnosis and treatment errors., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials or audits.
Mitigation Strategy
Use specific terminology, Include test results
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Ensure documentation explicitly states 'recurrent' if using A04.71.
Impact
Failure to document recurrence status can lead to incorrect coding.
Mitigation Strategy
Implement checklist for CDI 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 C. difficile Unspecified, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for C. difficile Unspecified
Use these documentation templates to ensure complete and accurate documentation for C. difficile Unspecified. These templates include all required elements for proper coding and billing.
Hospital admission for CDI
Specialty: Infectious DiseaseRequired Elements
- Onset of symptoms
- Frequency of diarrhea
- Test results
- Recurrence status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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