ICD-10 Coding for Ground Glass Opacity(R91.8, J18.9, U07.1)
Complete ICD-10-CM coding and documentation guide for Ground Glass Opacity. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ground Glass Opacity
R91-R94Primary Range
Abnormal findings on diagnostic imaging of lung
This range includes codes for abnormal imaging findings, such as ground glass opacity, which is coded under R91.8.
Pneumonia and influenza
This range includes codes for pneumonia, which is a common underlying cause of ground glass opacity.
Emergency use of U07.1 for COVID-19
COVID-19 is a significant cause of ground glass opacity, coded under U07.1 when confirmed.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R91.8 | Other nonspecific abnormal finding of lung field | Use when GGO is identified on imaging without a specified underlying condition. |
|
| J18.9 | Pneumonia, unspecified organism | Use when GGO is due to pneumonia and the organism is not specified. |
|
| U07.1 | COVID-19, virus identified | Use when GGO is confirmed to be due to COVID-19. |
|
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 ground glass opacity
Essential facts and insights about Ground Glass Opacity
Primary ICD-10-CM Codes for ground glass opacity
Decision Criteria
clinical Criteria
- GGO identified on imaging with no clear etiology.
coding Criteria
- Underlying condition not specified or unknown.
Applicable To
- Ground glass opacity
Excludes
- Specific conditions causing GGO (e.g., pneumonia, COVID-19)
Clinical Validation Requirements
- Radiological report confirming GGO
- Clinical documentation linking GGO to a specific condition
Code-Specific Risks
- Coding R91.8 without specifying the underlying cause can lead to denials.
Coding Notes
- Always document the clinical significance of GGO and any associated conditions.
J18.9 - Pneumonia, unspecified organism
Use when GGO is due to pneumonia and the organism is not specified.
Applicable To
- Pneumonia NOS
Excludes
- Viral pneumonia (J12.-)
Clinical Validation Requirements
- Clinical diagnosis of pneumonia without organism specification
Coding Notes
Document the clinical presentation and any imaging findings.
U07.1 - COVID-19, virus identified
Use when GGO is confirmed to be due to COVID-19.
Applicable To
- COVID-19 confirmed by lab testing
Excludes
- Suspected COVID-19 without confirmation
Clinical Validation Requirements
- Positive SARS-CoV-2 PCR or antigen test
- Radiological evidence of GGO linked to COVID-19
Coding Notes
Document the positive test result and clinical correlation.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other specified interstitial pulmonary diseases
J84.89Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Ground Glass Opacity to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R91.8.
Impact
Clinical: May lead to inadequate treatment planning., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.
Mitigation Strategy
Always include laterality and distribution in documentation., Use structured templates for imaging findings.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate representation of patient condition.
Mitigation Strategy
Always code the underlying condition first if known.
Impact
Failure to sequence the underlying condition before R91.8.
Mitigation Strategy
Educate coders on proper sequencing rules.
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 Ground Glass Opacity, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ground Glass Opacity
Use these documentation templates to ensure complete and accurate documentation for Ground Glass Opacity. These templates include all required elements for proper coding and billing.
GGO in COVID-19 pneumonia
Specialty: PulmonologyRequired Elements
- Imaging findings
- COVID-19 test results
- Clinical correlation
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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