ICD-10 Coding for Candidal Esophagitis(B37.81)
Complete ICD-10-CM coding and documentation guide for Candidal Esophagitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Candidal Esophagitis
B37.0-B37.9Primary Range
Candidiasis
This range includes all forms of candidiasis, with B37.81 specifically for candidal esophagitis.
Key Information: ICD-10 code for candidal esophagitis
Essential facts and insights about Candidal Esophagitis
Primary ICD-10-CM Code for candidal esophagitis
Decision Criteria
clinical Criteria
- Presence of white plaques on endoscopy and biopsy confirmation
documentation Criteria
- Biopsy results confirming Candida
Applicable To
- Esophageal candidiasis
Excludes
- Oral candidiasis (B37.0)
Clinical Validation Requirements
- Endoscopic visualization of white plaques
- Biopsy or PAS stain confirming Candida hyphae/pseudohyphae
Code-Specific Risks
- Misclassification if not confirmed by biopsy
- Confusion with other forms of esophagitis
Coding Notes
- Ensure documentation specifies Candida as the causative organism.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
HIV disease
B20Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Candidal Esophagitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B37.81.
Impact
Clinical: May lead to incorrect treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Ensure documentation specifies Candida., Use biopsy results to confirm diagnosis.
Impact
Reimbursement: Incorrect DRG assignment may reduce reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use B37.81 when Candida is confirmed as the cause.
Impact
Claims without biopsy confirmation may be audited.
Mitigation Strategy
Ensure all claims include biopsy results.
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 Candidal Esophagitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Candidal Esophagitis
Use these documentation templates to ensure complete and accurate documentation for Candidal Esophagitis. These templates include all required elements for proper coding and billing.
HIV patient with candidal esophagitis
Specialty: GastroenterologyRequired Elements
- Symptoms of odynophagia
- Endoscopic findings
- Biopsy results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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