ICD-10 Coding for History of Chronic Tonsillitis(Z86.19, J35.01)
Complete ICD-10-CM coding and documentation guide for History of Chronic Tonsillitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to History of Chronic Tonsillitis
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z86.19 | Personal history of other infectious and parasitic diseases | Use when chronic tonsillitis is resolved and relevant to current care. |
|
| J35.01 | Chronic tonsillitis | Use for active cases of chronic tonsillitis. |
|
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 history of chronic tonsillitis
Essential facts and insights about History of Chronic Tonsillitis
Primary ICD-10-CM Codes for history of chronic tonsillitis
Decision Criteria
documentation Criteria
- Document resolution and past treatment of chronic tonsillitis.
Applicable To
- Resolved chronic tonsillitis
Excludes
- Active chronic tonsillitis (J35.01)
Clinical Validation Requirements
- Documentation of resolution of chronic tonsillitis
- Past treatment details, such as tonsillectomy
Code-Specific Risks
- Incorrectly using for active tonsillitis
Coding Notes
- Ensure documentation clearly states the resolution of the condition.
J35.01 - Chronic tonsillitis
Use for active cases of chronic tonsillitis.
Applicable To
- Active chronic tonsillitis
Excludes
- Resolved chronic tonsillitis (Z86.19)
Clinical Validation Requirements
- Symptoms persisting for more than 3 months
- Objective findings such as tonsillar hypertrophy
Coding Notes
Ensure active symptoms are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Follow-up examination after treatment for conditions other than malignant neoplasms
Z09Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting History of Chronic Tonsillitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z86.19.
Impact
Clinical: Inaccurate patient history, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Ensure documentation includes treatment and resolution details, Regular training on coding guidelines
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient history records.
Mitigation Strategy
Use Z86.19 for resolved cases with proper documentation.
Impact
Using Z codes without proper documentation of resolution.
Mitigation Strategy
Ensure documentation clearly states the resolution of the condition.
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 History of Chronic Tonsillitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for History of Chronic Tonsillitis
Use these documentation templates to ensure complete and accurate documentation for History of Chronic Tonsillitis. These templates include all required elements for proper coding and billing.
Post-tonsillectomy follow-up
Specialty: OtolaryngologyRequired Elements
- Past medical history
- Current symptoms
- Resolution of chronic tonsillitis
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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