ICD-10 Coding for Condyloma(A63.0, B07.8)
Complete ICD-10-CM coding and documentation guide for Condyloma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Condyloma
A63.0Primary Range
Anogenital warts
Primary code for HPV-confirmed anogenital warts, including condyloma acuminatum.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A63.0 | Anogenital warts | Use when HPV is confirmed via testing. |
|
| B07.8 | Other viral warts | Use when warts are documented without HPV confirmation. |
|
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 condyloma
Essential facts and insights about Condyloma
Primary ICD-10-CM Codes for condyloma
Decision Criteria
clinical Criteria
- HPV confirmation via PCR or biopsy.
documentation Criteria
- Detailed description of lesion morphology and location.
Applicable To
- Condyloma acuminatum
Excludes
- Condyloma latum (A51.31)
Clinical Validation Requirements
- PCR showing HPV-6/11
- Biopsy with koilocytosis
Code-Specific Risks
- Incorrectly coding as B07.9 when HPV is confirmed.
Coding Notes
- Ensure HPV confirmation through clinical testing.
B07.8 - Other viral warts
Use when warts are documented without HPV confirmation.
Clinical Validation Requirements
- Clinical diagnosis without HPV confirmation.
Coding Notes
Avoid if HPV is confirmed.
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 Condyloma to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A63.0.
Impact
Clinical: Potential misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Denied claims due to insufficient documentation.
Mitigation Strategy
Include HPV test results in documentation., Specify lesion morphology and location.
Impact
Reimbursement: Incorrect DRG assignment leading to underpayment., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use A63.0 with B97.7 for confirmed HPV cases.
Impact
Lack of HPV confirmation in records.
Mitigation Strategy
Implement mandatory HPV testing 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 Condyloma, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Condyloma
Use these documentation templates to ensure complete and accurate documentation for Condyloma. These templates include all required elements for proper coding and billing.
Diagnosis of HPV-confirmed anal condyloma
Specialty: DermatologyRequired Elements
- Anatomic site
- Lesion morphology
- HPV test results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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