ICD-10 Coding for Head Lice(B85.0, B85.2)
Complete ICD-10-CM coding and documentation guide for Head Lice. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Head Lice
B85-B89Primary Range
Pediculosis and phthiriasis
This range includes all types of lice infestations, including head lice, which is the primary focus.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| B85.0 | Pediculosis due to Pediculus humanus capitis | Use when head lice are confirmed through visual inspection or diagnostic tests. |
|
| B85.2 | Unspecified pediculosis | Use when the type of lice is not specified in documentation. |
|
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 head lice
Essential facts and insights about Head Lice
Primary ICD-10-CM Codes for head lice
Decision Criteria
clinical Criteria
- Presence of live lice or nits within 1 cm of the scalp
Clinical Validation Requirements
- Visual confirmation of live lice or nits
- Wet combing test results
Code-Specific Risks
- Using B85.2 when head lice are specified
Coding Notes
- Ensure documentation specifies head lice to avoid unspecified coding.
B85.2 - Unspecified pediculosis
Use when the type of lice is not specified in documentation.
Excludes
- Head lice (B85.0)
Clinical Validation Requirements
- Lack of specific identification of lice type
Coding Notes
Avoid using if specific lice type is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other pruritus
L29.8Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Phthiriasis
B85.3Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Head Lice to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B85.0.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Train staff on documentation requirements.
Impact
Reimbursement: May lead to incorrect billing and reimbursement issues., Compliance: Non-compliance with coding specificity requirements., Data Quality: Decreases accuracy of health records.
Mitigation Strategy
Use B85.0 for confirmed head lice cases.
Impact
Risk of audits due to unspecified lice type.
Mitigation Strategy
Ensure detailed documentation of lice type.
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 Head Lice, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Head Lice
Use these documentation templates to ensure complete and accurate documentation for Head Lice. These templates include all required elements for proper coding and billing.
Pediatric head lice diagnosis
Specialty: PediatricsRequired Elements
- Patient age and symptoms
- Visual confirmation of lice
- Treatment plan
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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