ICD-10 Coding for Epididymo-orchitis(N45.3, N45.4)
Complete ICD-10-CM coding and documentation guide for Epididymo-orchitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Epididymo-orchitis
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N45.3 | Epididymo-orchitis | Use when both epididymis and testis are inflamed without abscess formation. |
|
| N45.4 | Abscess of epididymis or testis | Use when there is confirmed abscess formation in the epididymis or testis. |
|
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 epididymo-orchitis
Essential facts and insights about Epididymo-orchitis
Primary ICD-10-CM Codes for epididymo orchitis
Decision Criteria
clinical Criteria
- Documented inflammation of both epididymis and testis.
coding Criteria
- Use additional codes for infectious agents.
Clinical Validation Requirements
- Scrotal ultrasound showing increased vascularity
- Positive urine culture or NAAT for infectious agent
Code-Specific Risks
- Failure to document laterality
- Omission of infectious agent code
Coding Notes
- Ensure documentation includes laterality and infectious agent when known.
N45.4 - Abscess of epididymis or testis
Use when there is confirmed abscess formation in the epididymis or testis.
Applicable To
- Abscess formation in epididymis or testis
Excludes
- N44.0 Torsion of testis
- N48.22 Scrotal abscess
Clinical Validation Requirements
- Ultrasound confirming abscess
- Culture results indicating infection
Coding Notes
Ensure abscess is confirmed via imaging before coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Escherichia coli [E. coli] as the cause of diseases classified elsewhere
B96.2Differential 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 Epididymo-orchitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N45.3.
Impact
Clinical: Incomplete clinical picture., Regulatory: Potential audit risk., Financial: Missed opportunities for accurate reimbursement.
Mitigation Strategy
Review lab results for infectious agents., Ensure additional codes are included in the claim.
Impact
Reimbursement: Incorrect DRG assignment leading to lower reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Confirm abscess via imaging and use N45.4
Impact
Failure to sequence codes correctly can lead to audit issues.
Mitigation Strategy
Train staff on proper sequencing rules for epididymo-orchitis.
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 Epididymo-orchitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Epididymo-orchitis
Use these documentation templates to ensure complete and accurate documentation for Epididymo-orchitis. These templates include all required elements for proper coding and billing.
Emergency Department Presentation
Specialty: UrologyRequired Elements
- History of present illness
- Physical examination findings
- Imaging results
- Laboratory results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Epididymo-orchitis? Ask your questions below.