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ICD-10 Coding for Exposure to Streptococcal Infections(Z20.818, J02.0)

Complete ICD-10-CM coding and documentation guide for Exposure to Streptococcal Infections. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Strep ExposureContact with Streptococcus

Related ICD-10 Code Ranges

Complete code families applicable to Exposure to Streptococcal Infections

Z20-Z29Primary Range

Persons with potential health hazards related to communicable diseases

This range includes codes for exposure to various communicable diseases, including bacterial infections like streptococcal infections.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
Z20.818Contact with and (suspected) exposure to other bacterial communicable diseasesUse when a patient is asymptomatic but has been exposed to a confirmed case of streptococcal infection.
  • Documented contact with a confirmed case of streptococcal infection
  • No symptoms of active infection
J02.0Streptococcal pharyngitisUse when there is a confirmed active infection of streptococcal pharyngitis.
  • Positive rapid antigen detection test (RADT) or throat culture for Group A Streptococcus

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 exposure to strep

Essential facts and insights about Exposure to Streptococcal Infections

The ICD-10 code for exposure to streptococcal infections is Z20.818, used for asymptomatic patients with confirmed exposure.

Primary ICD-10-CM Codes for exposure to strep

Contact with and (suspected) exposure to other bacterial communicable diseases
Billable Code

Decision Criteria

clinical Criteria

  • Patient has documented exposure to a confirmed case of streptococcal infection.

coding Criteria

  • No symptoms of active infection present.

Applicable To

  • Exposure to streptococcal infections

Excludes

  • Exposure to viral communicable diseases (Z20.828)

Clinical Validation Requirements

  • Documented contact with a confirmed case of streptococcal infection
  • No symptoms of active infection

Code-Specific Risks

  • Incorrectly using for viral exposures
  • Using as primary code when symptoms are present

Coding Notes

  • Ensure documentation specifies the type of exposure and confirms it is bacterial.

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Streptococcal pharyngitis

J02.0
Use when there is a confirmed active infection following exposure.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Contact with and (suspected) exposure to other viral communicable diseases

Z20.828
Use for viral exposures, not bacterial like streptococcal.

Acute pharyngitis, unspecified

J02.9
Use when the cause of pharyngitis is not confirmed as streptococcal.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Exposure to Streptococcal Infections to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z20.818.

Impact

Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.

Mitigation Strategy

Train staff on specific documentation requirements, Use templates for consistency

Impact

Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate health data reporting.

Mitigation Strategy

Confirm the exposure is bacterial, not viral.

Impact

Lack of specific exposure details can lead to audit issues.

Mitigation Strategy

Ensure all exposure cases are documented with specific details.

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 Exposure to Streptococcal Infections, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Exposure to Streptococcal Infections

Use these documentation templates to ensure complete and accurate documentation for Exposure to Streptococcal Infections. These templates include all required elements for proper coding and billing.

Asymptomatic exposure to strep

Specialty: Primary Care

Required Elements

  • Exposure details
  • Absence of symptoms
  • Prophylactic measures

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient exposed to infection.
Good Documentation Example
Patient reports exposure to sibling with confirmed strep throat. No symptoms present. Prophylactic antibiotics prescribed.
Explanation
The good example provides specific exposure details and a clear treatment plan.

Need help with ICD-10 coding for Exposure to Streptococcal Infections? Ask your questions below.

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