ICD-10 Coding for Foley Catheter Problem(T83.511A, N39.0)
Complete ICD-10-CM coding and documentation guide for Foley Catheter Problem. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Foley Catheter Problem
T83.5Primary Range
Complications of urinary devices, implants and grafts
This range includes codes for complications related to urinary catheters, including infections and mechanical issues.
Other disorders of urinary system
Includes codes for urinary tract infections and other urinary symptoms that may be related to catheter use.
Encounter for fitting and adjustment of urinary devices
Used for routine maintenance and adjustment of urinary catheters without complications.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| T83.511A | Infection and inflammatory reaction due to indwelling urethral catheter | Use when a UTI is directly attributed to the catheter, with explicit documentation of causality. |
|
| N39.0 | Urinary tract infection, site not specified | Use when a UTI is present without a documented link to catheter use. |
|
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: How do you code a Foley catheter problem in ICD-10?
Essential facts and insights about Foley Catheter Problem
Primary ICD-10-CM Codes for foley catheter problem
Decision Criteria
clinical Criteria
- Presence of symptoms and lab results indicating infection due to catheter.
documentation Criteria
- Explicit statement linking UTI to catheter use.
Applicable To
- Catheter-associated urinary tract infection (CAUTI)
Excludes
- Non-catheter-associated UTI (N39.0)
Clinical Validation Requirements
- Urinalysis showing WBC >10/HPF
- Positive urine culture with >10^5 CFU/mL of uropathogen
Code-Specific Risks
- Misclassification as non-catheter-associated UTI
- Omission of causal language in documentation
Coding Notes
- Ensure documentation explicitly states the causal relationship between the catheter and the infection.
N39.0 - Urinary tract infection, site not specified
Use when a UTI is present without a documented link to catheter use.
Applicable To
- UTI without specified site
Excludes
- Catheter-associated UTI (T83.511A)
Clinical Validation Requirements
- Urinalysis with positive leukocyte esterase
- Positive urine culture
Coding Notes
Ensure no documentation suggests a catheter link if using this code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Dysuria
R30.0Differential 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 Foley Catheter Problem to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code T83.511A.
Impact
Clinical: Inadequate information for clinical management., Regulatory: Non-compliance with documentation standards., Financial: Potential denial of claims due to incomplete documentation.
Mitigation Strategy
Use templates that prompt for catheter details., Educate staff on documentation requirements.
Impact
Reimbursement: Potential underpayment due to incorrect DRG assignment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on catheter-associated infections.
Mitigation Strategy
Ensure documentation explicitly links the UTI to the catheter.
Impact
Incorrect POA flagging for catheter-associated infections can lead to audit issues.
Mitigation Strategy
Ensure accurate documentation of infection onset relative to catheter insertion.
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 Foley Catheter Problem, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Foley Catheter Problem
Use these documentation templates to ensure complete and accurate documentation for Foley Catheter Problem. These templates include all required elements for proper coding and billing.
CAUTI with Sepsis
Specialty: Infectious DiseaseRequired Elements
- Causal relationship documentation
- Sepsis symptoms and lab results
- Antibiotic treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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