ICD-10 Coding for Chlamydia(A56.01, A56.11)
Complete ICD-10-CM coding and documentation guide for Chlamydia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Chlamydia
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A56.01 | Chlamydial cystitis and urethritis | Use when chlamydial infection is confirmed in the urinary tract. |
|
| A56.11 | Chlamydial female pelvic inflammatory disease | Use when chlamydial infection is confirmed in the pelvic region. |
|
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 chlamydia
Essential facts and insights about Chlamydia
Primary ICD-10-CM Codes for chlamydia
Decision Criteria
clinical Criteria
- Presence of urinary symptoms and positive lab test
Applicable To
- Chlamydial urethritis
- Chlamydial cystitis
Excludes
- Gonococcal urethritis (A54.09)
Clinical Validation Requirements
- Positive NAAT test for C. trachomatis
- Symptoms of dysuria or urinary frequency
Code-Specific Risks
- Misclassification if based solely on symptoms without lab confirmation.
Coding Notes
- Ensure lab confirmation is documented.
A56.11 - Chlamydial female pelvic inflammatory disease
Use when chlamydial infection is confirmed in the pelvic region.
Applicable To
- Chlamydial salpingitis
- Chlamydial oophoritis
Excludes
- Non-chlamydial PID (N73.9)
Clinical Validation Requirements
- Positive NAAT test for C. trachomatis
- Clinical diagnosis of PID
Coding Notes
Document the specific site of infection.
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 Chlamydia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A56.01.
Impact
Clinical: Incomplete patient risk assessment., Regulatory: Potential audit issues., Financial: Missed opportunities for risk adjustment.
Mitigation Strategy
Always document sexual history and risk factors., Use templates to ensure completeness.
Impact
Reimbursement: Potential claim denials due to lack of evidence., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate health records and statistics.
Mitigation Strategy
Ensure all chlamydia diagnoses are supported by positive lab results.
Impact
High risk of audit failure if lab confirmation is not documented.
Mitigation Strategy
Implement mandatory lab result documentation for all chlamydia diagnoses.
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 Chlamydia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chlamydia
Use these documentation templates to ensure complete and accurate documentation for Chlamydia. These templates include all required elements for proper coding and billing.
Chlamydia screening in asymptomatic patient
Specialty: Family MedicineRequired Elements
- Patient demographics
- Reason for screening
- Test method and result
- Risk factors
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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