ICD-10 Coding for Congenital Adrenal Hyperplasia(E25.0)
Complete ICD-10-CM coding and documentation guide for Congenital Adrenal Hyperplasia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Congenital Adrenal Hyperplasia
E25.0-E25.9Primary Range
Congenital adrenogenital disorders
This range includes disorders related to enzyme deficiencies in adrenal steroidogenesis, primarily including CAH.
Congenital malformations of adrenal gland
Used for structural adrenal malformations, not enzyme deficiencies.
Key Information: ICD-10 code for congenital adrenal hyperplasia
Essential facts and insights about Congenital Adrenal Hyperplasia
Primary ICD-10-CM Code for congenital adrenal hyperplasia
Decision Criteria
clinical Criteria
- Presence of 21-hydroxylase deficiency confirmed by lab tests
documentation Criteria
- Detailed documentation of enzyme deficiency and genetic testing
Applicable To
- 21-hydroxylase deficiency
Excludes
Clinical Validation Requirements
- Elevated 17-hydroxyprogesterone (17-OHP) levels via LC-MS/MS
- CYP21A2 mutation analysis
Code-Specific Risks
- Incorrectly coding structural malformations as enzyme deficiencies
Coding Notes
- Ensure enzyme deficiency is documented before using E25.0.
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 Congenital Adrenal Hyperplasia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E25.0.
Impact
Clinical: Misdiagnosis risk, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Use templates with required fields, Regular training on documentation standards
Impact
Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Confirm enzyme deficiency and use E25.0.
Impact
Lack of specific enzyme deficiency documentation.
Mitigation Strategy
Implement mandatory documentation templates.
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 Congenital Adrenal Hyperplasia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Congenital Adrenal Hyperplasia
Use these documentation templates to ensure complete and accurate documentation for Congenital Adrenal Hyperplasia. These templates include all required elements for proper coding and billing.
Newborn screening follow-up
Specialty: PediatricsRequired Elements
- 17-OHP levels
- CYP21A2 mutation analysis
- Electrolyte levels
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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