ICD-10 Coding for Positive Thyroid Peroxidase Antibodies(E06.3, R94.6)
Complete ICD-10-CM coding and documentation guide for Positive Thyroid Peroxidase Antibodies. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Positive Thyroid Peroxidase Antibodies
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E06.3 | Autoimmune thyroiditis | Use when TPO antibodies are elevated and there is clinical evidence of autoimmune thyroiditis. |
|
| R94.6 | Abnormal thyroid function studies | Use when TPO antibodies are elevated but no specific thyroid condition is diagnosed. |
|
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 positive thyroid peroxidase antibodies
Essential facts and insights about Positive Thyroid Peroxidase Antibodies
Primary ICD-10-CM Codes for disease positive thyroid peroxidase antibodies
Decision Criteria
clinical Criteria
- Presence of elevated TPO antibodies and hypothyroid symptoms
coding Criteria
- Do not code E06.3 with E03.1
Applicable To
- Hashimoto's thyroiditis
Excludes
- E03.1 (Other hypothyroidism)
Clinical Validation Requirements
- Elevated TPO antibodies >9 IU/mL
- Symptoms of hypothyroidism
- TSH >4.5 μIU/mL
Code-Specific Risks
- Incorrectly coding both E06.3 and E03.1 together.
Coding Notes
- Ensure documentation links TPO antibody levels to clinical symptoms of thyroiditis.
R94.6 - Abnormal thyroid function studies
Use when TPO antibodies are elevated but no specific thyroid condition is diagnosed.
Clinical Validation Requirements
- Elevated TPO antibodies without a specific thyroid diagnosis
Coding Notes
Query provider if TPO antibodies are elevated to determine if autoimmune thyroiditis is present.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Abnormal thyroid function studies
R94.6Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Positive Thyroid Peroxidase Antibodies to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E06.3.
Impact
Clinical: May lead to misdiagnosis or incomplete diagnosis., Regulatory: Fails to meet documentation standards., Financial: Can result in claim denials or audits.
Mitigation Strategy
Always include quantitative values and reference ranges., Link lab findings to clinical symptoms.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Violates ICD-10 Excludes1 note., Data Quality: Leads to inaccurate clinical data representation.
Mitigation Strategy
Use E06.3 alone as it includes hypothyroidism in autoimmune cases.
Impact
Failure to document quantitative TPO levels can lead to audit issues.
Mitigation Strategy
Ensure all lab results include quantitative values and reference ranges.
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 Positive Thyroid Peroxidase Antibodies, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Positive Thyroid Peroxidase Antibodies
Use these documentation templates to ensure complete and accurate documentation for Positive Thyroid Peroxidase Antibodies. These templates include all required elements for proper coding and billing.
Patient with elevated TPO antibodies and hypothyroid symptoms
Specialty: EndocrinologyRequired Elements
- Symptoms of hypothyroidism
- TPO antibody levels with reference range
- TSH and Free T4 levels
- Assay method
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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