ICD-10 Coding for Herpetic Stomatitis(B00.1, B00.2)
Complete ICD-10-CM coding and documentation guide for Herpetic Stomatitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Herpetic Stomatitis
B00.0-B00.9Primary Range
Herpesviral [herpes simplex] infections
This range includes codes for herpesviral infections affecting various anatomical sites, including oral and pharyngeal regions.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| B00.1 | Herpesviral vesicular dermatitis | Use when vesicular lesions are present without gingival involvement. |
|
| B00.2 | Herpesviral gingivostomatitis and pharyngotonsillitis | Use when gingival or pharyngeal involvement is documented. |
|
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 herpetic stomatitis
Essential facts and insights about Herpetic Stomatitis
Primary ICD-10-CM Codes for herpetic stomatitis
Decision Criteria
clinical Criteria
- Vesicular lesions without gingival involvement
Applicable To
- Herpes labialis
- Cold sores
Excludes
- Herpesviral gingivostomatitis and pharyngotonsillitis (B00.2)
Clinical Validation Requirements
- Presence of vesicular lesions on lips or oral mucosa
- PCR confirmation of HSV
Code-Specific Risks
- Misclassification if gingival involvement is present
Coding Notes
- Ensure documentation specifies the absence of gingival involvement to use B00.1.
B00.2 - Herpesviral gingivostomatitis and pharyngotonsillitis
Use when gingival or pharyngeal involvement is documented.
Applicable To
- Primary herpetic gingivostomatitis
Excludes
- Herpesviral vesicular dermatitis (B00.1)
Clinical Validation Requirements
- Fiery red gingiva with vesicular lesions
- PCR or culture confirmation of HSV
Coding Notes
Ensure documentation specifies gingival or pharyngeal involvement to use B00.2.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Fever, unspecified
R50.9Differential 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 Herpetic Stomatitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B00.1.
Impact
Clinical: Inaccurate diagnosis and treatment, Regulatory: Potential audit issues, Financial: Reduced reimbursement
Mitigation Strategy
Use specific terminology, Include diagnostic test results
Impact
Reimbursement: Potential underpayment due to lack of specificity, Compliance: Non-compliance with coding guidelines, Data Quality: Decreased accuracy in clinical data
Mitigation Strategy
Ensure documentation supports the use of specific codes like B00.1 or B00.2.
Impact
Risk of audits due to use of unspecified codes.
Mitigation Strategy
Ensure documentation supports the use of specific codes like B00.1 or B00.2.
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 Herpetic Stomatitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Herpetic Stomatitis
Use these documentation templates to ensure complete and accurate documentation for Herpetic Stomatitis. These templates include all required elements for proper coding and billing.
Pediatric Presentation of Herpetic Stomatitis
Specialty: PediatricsRequired Elements
- Oral examination findings
- Viral confirmation method
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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