ICD-10 Coding for History of Endometriosis(Z87.42, N80.x)
Complete ICD-10-CM coding and documentation guide for History of Endometriosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to History of Endometriosis
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z87.42 | Personal history of endometriosis | Use when the patient has a history of endometriosis that is no longer active. |
|
| N80.x | Endometriosis | Use when there is active disease with symptoms or treatment. |
|
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 endometriosis
Essential facts and insights about History of Endometriosis
Primary ICD-10-CM Codes for history of endometriosis
Decision Criteria
clinical Criteria
- No active symptoms or treatment for endometriosis.
Applicable To
- Resolved endometriosis
Excludes
- Active endometriosis (N80.x)
Clinical Validation Requirements
- Documentation of resolved endometriosis with no current symptoms or treatment.
Code-Specific Risks
- Incorrectly using for active endometriosis cases.
Coding Notes
- Ensure the condition is resolved before using this code.
N80.x - Endometriosis
Use when there is active disease with symptoms or treatment.
Applicable To
- Active endometriosis
Excludes
- Resolved endometriosis (Z87.42)
Clinical Validation Requirements
- Laparoscopic confirmation or imaging evidence of active endometriosis.
Coding Notes
Document specific location and severity for accurate coding.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting History of Endometriosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z87.42.
Impact
Clinical: Misrepresentation of patient's current health status., Regulatory: Potential audit issues., Financial: Incorrect billing and potential claim denials.
Mitigation Strategy
Ensure thorough documentation of surgical history and current status.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Use N80.x codes for active cases.
Impact
Using history codes for active conditions.
Mitigation Strategy
Regular training and audits to ensure correct code usage.
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 Endometriosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for History of Endometriosis
Use these documentation templates to ensure complete and accurate documentation for History of Endometriosis. These templates include all required elements for proper coding and billing.
Post-operative follow-up for resolved endometriosis
Specialty: GynecologyRequired Elements
- Patient history
- Surgical history
- Current symptoms
- Physical examination findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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