ICD-10 Coding for Genital Lesion(A63.0, D07.1, N90.89)
Complete ICD-10-CM coding and documentation guide for Genital Lesion. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Genital Lesion
A63-A64Primary Range
Other predominantly sexually transmitted diseases
Includes conditions like anogenital warts caused by HPV.
Noninflammatory disorders of female genital tract
Covers noninflammatory vulvar disorders that may present as lesions.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A63.0 | Anogenital (venereal) warts | Use when anogenital warts are confirmed by HPV testing. |
|
| D07.1 | Carcinoma in situ of vulva | Use for non-invasive vulvar carcinoma confirmed by biopsy. |
|
| N90.89 | Other specified noninflammatory disorders of vulva and perineum | Use for chronic noninflammatory vulvar disorders confirmed by biopsy. |
|
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 genital lesions
Essential facts and insights about Genital Lesion
Primary ICD-10-CM Codes for genital lesion
Decision Criteria
clinical Criteria
- Presence of HPV positive test
Applicable To
- Condyloma acuminatum
Excludes
- Vulvar carcinoma in situ (D07.1)
Clinical Validation Requirements
- HPV PCR positive
- Visual confirmation of warts
Code-Specific Risks
- Incorrectly coding without HPV confirmation
Coding Notes
- Ensure HPV confirmation is documented.
D07.1 - Carcinoma in situ of vulva
Use for non-invasive vulvar carcinoma confirmed by biopsy.
Applicable To
- Paget’s disease of vulva
Excludes
- Invasive vulvar cancer (C51 series)
Clinical Validation Requirements
- Biopsy confirmation
- p16 IHC positive
Coding Notes
Ensure biopsy results are documented.
N90.89 - Other specified noninflammatory disorders of vulva and perineum
Use for chronic noninflammatory vulvar disorders confirmed by biopsy.
Applicable To
- Lichen sclerosus
Excludes
- Inflammatory disorders of vulva (N76.4)
Clinical Validation Requirements
- Chronic lesions without infection
- Biopsy confirmation
Coding Notes
Document biopsy results to support diagnosis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Unsatisfactory vaginal smear
R87.625Differential 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 Genital Lesion to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A63.0.
Impact
Clinical: Inadequate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential reimbursement issues.
Mitigation Strategy
Always document lesion size in cm.
Impact
Reimbursement: May lead to underpayment or denial., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data representation.
Mitigation Strategy
Use appropriate codes for multiple lesions, such as 17003 + 17004.
Impact
Reimbursement: Potential denial of E/M service payment., Compliance: Failure to meet billing requirements., Data Quality: Inaccurate service documentation.
Mitigation Strategy
Use modifier 25 when billing E/M services with procedures.
Impact
Failure to document HPV confirmation can lead to audit issues.
Mitigation Strategy
Ensure HPV PCR results are included in patient records.
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 Genital Lesion, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Genital Lesion
Use these documentation templates to ensure complete and accurate documentation for Genital Lesion. These templates include all required elements for proper coding and billing.
Documenting genital lesions in gynecology
Specialty: GynecologyRequired Elements
- Lesion location
- Lesion count
- Size in cm
- Morphology
- Diagnostic method
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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