ICD-10 Coding for Eliquis(I48.91, Z79.01, T45.515A)
Complete ICD-10-CM coding and documentation guide for Eliquis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Eliquis
I48-I49Primary Range
Atrial fibrillation and flutter
Primary conditions treated with Eliquis include atrial fibrillation.
Long-term (current) drug therapy
Used to indicate long-term use of anticoagulants like Eliquis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I48.91 | Unspecified atrial fibrillation | Use when documenting atrial fibrillation as the primary condition treated with Eliquis. |
|
| Z79.01 | Long-term (current) use of anticoagulants | Use as a secondary code to indicate long-term anticoagulant therapy. |
|
| T45.515A | Adverse effect of anticoagulants, initial encounter | Use for documenting adverse effects directly linked to Eliquis. |
|
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 Eliquis
Essential facts and insights about Eliquis
Primary ICD-10-CM Codes for eliquis
Decision Criteria
clinical Criteria
- Presence of chronic atrial fibrillation
Applicable To
- Chronic nonvalvular atrial fibrillation
Excludes
- Valvular atrial fibrillation
Clinical Validation Requirements
- ECG confirmation or progress note stating 'AFib remains present'
Code-Specific Risks
- Ensure specificity in documentation to avoid unspecified codes.
Coding Notes
- Ensure documentation specifies 'nonvalvular' if applicable.
Z79.01 - Long-term (current) use of anticoagulants
Use as a secondary code to indicate long-term anticoagulant therapy.
Applicable To
- Chronic use of Eliquis
Clinical Validation Requirements
- ≥3 consecutive months of Eliquis use AND indication linked to chronic condition
Coding Notes
Document the specific anticoagulant and condition being treated.
T45.515A - Adverse effect of anticoagulants, initial encounter
Use for documenting adverse effects directly linked to Eliquis.
Applicable To
- Bleeding complications due to Eliquis
Clinical Validation Requirements
- Bleeding event and provider attribution to Eliquis
Coding Notes
Document specific bleeding type and relation to Eliquis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long-term (current) use of anticoagulants
Z79.01Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Eliquis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I48.91.
Impact
Clinical: Leads to unclear treatment plans., Regulatory: Increases risk of audit issues., Financial: May result in denied claims.
Mitigation Strategy
Use specific terms like 'Eliquis for chronic AFib'.
Impact
Reimbursement: May lead to incorrect DRG assignment., Compliance: Risk of non-compliance with CMS guidelines., Data Quality: Impacts accuracy of patient records.
Mitigation Strategy
Specify 'Eliquis for chronic nonvalvular atrial fibrillation' in documentation.
Impact
Use of unspecified codes can trigger audits.
Mitigation Strategy
Ensure documentation is specific and complete.
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 Eliquis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Eliquis
Use these documentation templates to ensure complete and accurate documentation for Eliquis. These templates include all required elements for proper coding and billing.
Chronic nonvalvular atrial fibrillation management
Specialty: CardiologyRequired Elements
- Indication for Eliquis
- Dosage
- Monitoring plan
- Adverse effects
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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