ICD-10 Coding for Haemophilus influenzae(J14, B96.3)
Complete ICD-10-CM coding and documentation guide for Haemophilus influenzae. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Haemophilus influenzae
J09-J18Primary Range
Influenza and pneumonia
This range includes codes for pneumonia due to various organisms, including Haemophilus influenzae.
Bacterial and viral infectious agents
This range includes codes for identifying infectious agents causing diseases classified elsewhere, such as Haemophilus influenzae.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| J14 | Pneumonia due to Haemophilus influenzae | Use when pneumonia is confirmed to be caused by Haemophilus influenzae, with appropriate lab confirmation. |
|
| B96.3 | Haemophilus influenzae as the cause of diseases classified elsewhere | Use as an ancillary code to specify Haemophilus influenzae as the causative organism in other diseases. |
|
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 Haemophilus influenzae pneumonia
Essential facts and insights about Haemophilus influenzae
Primary ICD-10-CM Codes for haemophilus influenzae
Decision Criteria
clinical Criteria
- Confirmed Haemophilus influenzae infection via lab tests
documentation Criteria
- Explicit provider documentation of Haemophilus influenzae as the cause
Applicable To
- Pneumonia due to Haemophilus influenzae
Excludes
- Congenital pneumonia (P23.6)
Clinical Validation Requirements
- Provider documentation confirming Haemophilus influenzae as the causative organism
- Positive sputum culture or PCR for Haemophilus influenzae
Code-Specific Risks
- Incorrectly coding when only colonization is present without symptoms
Coding Notes
- Ensure documentation explicitly links Haemophilus influenzae to the pneumonia diagnosis.
B96.3 - Haemophilus influenzae as the cause of diseases classified elsewhere
Use as an ancillary code to specify Haemophilus influenzae as the causative organism in other diseases.
Applicable To
- Haemophilus influenzae as the causative organism
Clinical Validation Requirements
- Lab confirmation of Haemophilus influenzae in a disease classified elsewhere
Coding Notes
Ensure proper sequencing with the primary disease code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Haemophilus influenzae as the cause of diseases classified elsewhere
B96.3Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Haemophilus influenzae to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code J14.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials or reduced reimbursement.
Mitigation Strategy
Ensure lab confirmation is documented., Use specific codes for identified organisms.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate data on disease prevalence and treatment.
Mitigation Strategy
Always pair B96.3 with a primary code for the disease caused by Haemophilus influenzae.
Impact
Failure to sequence influenza codes before pneumonia codes when both are present.
Mitigation Strategy
Educate coding staff on sequencing rules and provide decision support tools.
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 Haemophilus influenzae, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Haemophilus influenzae
Use these documentation templates to ensure complete and accurate documentation for Haemophilus influenzae. These templates include all required elements for proper coding and billing.
Pneumonia due to Haemophilus influenzae
Specialty: PulmonologyRequired Elements
- Diagnosis confirmation
- Lab results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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