ICD-10 Coding for Herpes Zoster (Shingles)(B02.9, B02.3)
Complete ICD-10-CM coding and documentation guide for Herpes Zoster (Shingles). Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Herpes Zoster (Shingles)
B02Primary Range
Zoster [herpes zoster]
This range includes all codes related to herpes zoster, including complications and specific manifestations.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| B02.9 | Zoster without complications | Use for cases of shingles without any complications. |
|
| B02.3 | Zoster ocular disease | Use when shingles affects the eye. |
|
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 herpes zoster
Essential facts and insights about Herpes Zoster (Shingles)
Primary ICD-10-CM Codes for herpes zoster shingles
Decision Criteria
clinical Criteria
- Presence of vesicular rash in a single dermatome
Applicable To
- Uncomplicated shingles
Excludes
- Postherpetic neuralgia (G53.0)
Clinical Validation Requirements
- Vesicular rash in a dermatomal distribution
- PCR positive for VZV
Code-Specific Risks
- Misclassification if complications are present but not documented.
Coding Notes
- Ensure documentation of rash distribution and PCR results.
B02.3 - Zoster ocular disease
Use when shingles affects the eye.
Applicable To
- Herpes zoster ophthalmicus
Excludes
- Keratitis due to other causes (H16.9)
Clinical Validation Requirements
- Ocular involvement confirmed by slit lamp exam
- PCR positive for VZV
Coding Notes
Document ocular findings and confirm VZV involvement.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for immunization
Z23Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Herpes Zoster (Shingles) to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B02.9.
Impact
Clinical: Misleading clinical history., Regulatory: Non-compliance with coding standards., Financial: Potential claim rejections.
Mitigation Strategy
Use Z86.19 for history of shingles.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Code G53.0 only after 90 days post-rash.
Impact
Failure to sequence disseminated zoster before HIV in HIV+ patients.
Mitigation Strategy
Review sequencing rules and ensure correct order.
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 Herpes Zoster (Shingles), with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Herpes Zoster (Shingles)
Use these documentation templates to ensure complete and accurate documentation for Herpes Zoster (Shingles). These templates include all required elements for proper coding and billing.
Acute shingles presentation
Specialty: General PracticeRequired Elements
- History of present illness
- Rash description
- Pain characteristics
- PCR results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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