ICD-10 Coding for Functional Quadriplegia(R53.2)
Complete ICD-10-CM coding and documentation guide for Functional Quadriplegia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Functional Quadriplegia
Key Information: ICD-10 code for functional quadriplegia
Essential facts and insights about Functional Quadriplegia
Primary ICD-10-CM Code for functional quadriplegia
Decision Criteria
clinical Criteria
- Patient is completely immobile without spinal cord injury.
documentation Criteria
- Documentation must link immobility to another medical condition.
Applicable To
- Complete immobility due to severe debility or frailty
Clinical Validation Requirements
- Total dependence for all ADLs
- No spinal cord injury on imaging
- Underlying conditions like advanced dementia or severe arthritis
Code-Specific Risks
- Confusion with neurological quadriplegia
- Incorrect DRG assignment
Coding Notes
- Ensure documentation explicitly states no spinal cord injury.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Dementia in other diseases classified elsewhere with behavioral disturbance
F02.81Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Quadriplegia, unspecified
G82.50Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Functional Quadriplegia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R53.2.
Impact
Clinical: Misrepresentation of patient's condition., Regulatory: Potential audit issues., Financial: Incorrect billing and reimbursement.
Mitigation Strategy
Use 'functional quadriplegia' in documentation., Clarify absence of spinal injury.
Impact
Reimbursement: Incorrect DRG assignment affects reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use G82.50 for neurological quadriplegia.
Impact
Auditors may target cases lacking explicit documentation of total care requirements.
Mitigation Strategy
Ensure thorough documentation of ADL dependence.
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 Functional Quadriplegia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Functional Quadriplegia
Use these documentation templates to ensure complete and accurate documentation for Functional Quadriplegia. These templates include all required elements for proper coding and billing.
Geriatric patient with advanced dementia
Specialty: GeriatricsRequired Elements
- Complete immobility
- Total care for ADLs
- No spinal cord injury
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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