ICD-10 Coding for Enterovirus Infections(B97.1, B97.11)
Complete ICD-10-CM coding and documentation guide for Enterovirus Infections. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Enterovirus Infections
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| B97.1 | Viral agents as the cause of diseases classified elsewhere | Use when enterovirus is identified as the causative agent of another condition. |
|
| B97.11 | Coxsackievirus as the cause of diseases classified elsewhere | Use when Coxsackievirus is confirmed as the causative agent. |
|
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 enterovirus
Essential facts and insights about Enterovirus Infections
Primary ICD-10-CM Codes for enteroviruses
Decision Criteria
clinical Criteria
- PCR confirmation of enterovirus
Applicable To
- Enterovirus infections
Excludes
- Viral infections not elsewhere classified
Clinical Validation Requirements
- PCR confirmation of enterovirus in clinical specimens
Code-Specific Risks
- Incorrectly using as a primary diagnosis
Coding Notes
- Ensure enterovirus is confirmed via laboratory testing.
B97.11 - Coxsackievirus as the cause of diseases classified elsewhere
Use when Coxsackievirus is confirmed as the causative agent.
Applicable To
- Coxsackievirus infections
Excludes
- Other enterovirus infections
Clinical Validation Requirements
- PCR confirmation of Coxsackievirus
Coding Notes
Ensure documentation specifies Coxsackievirus.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Contact with and (suspected) exposure to other viral communicable diseases
Z20.828Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Enterovirus Infections to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B97.1.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.
Mitigation Strategy
Always confirm and document specific virus type., Use laboratory results to guide documentation.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate representation of patient conditions.
Mitigation Strategy
Always pair with a primary condition code.
Impact
Failure to sequence manifestation codes before B97.1.
Mitigation Strategy
Educate coders on proper sequencing rules.
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 Enterovirus Infections, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Enterovirus Infections
Use these documentation templates to ensure complete and accurate documentation for Enterovirus Infections. These templates include all required elements for proper coding and billing.
Enteroviral Meningitis
Specialty: NeurologyRequired Elements
- Patient symptoms
- Laboratory confirmation
- Specific enterovirus type
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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