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ICD-10 Coding for History of Lupus(Z86.29, M32.9)

Complete ICD-10-CM coding and documentation guide for History of Lupus. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

History of Systemic Lupus ErythematosusHistory of SLE

Related ICD-10 Code Ranges

Complete code families applicable to History of Lupus

Z86-Z87Primary Range

Personal history of certain other diseases

This range includes codes for personal history of diseases, including resolved systemic lupus erythematosus.

Systemic lupus erythematosus

This range includes codes for active systemic lupus erythematosus and its complications.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
Z86.29Personal history of other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanismUse when SLE is resolved and not impacting current care.
  • Explicit documentation of resolved SLE
  • No current treatment or symptoms
M32.9Systemic lupus erythematosus, unspecifiedUse for active SLE when organ involvement is not specified.
  • Positive ANA test
  • Clinical symptoms consistent with SLE

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 lupus

Essential facts and insights about History of Lupus

The ICD-10 code for a history of resolved systemic lupus erythematosus is Z86.29.

Primary ICD-10-CM Codes for history of lupus

Personal history of other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
Non-billable Code

Decision Criteria

documentation Criteria

  • Document that SLE is resolved and no longer requires treatment.

Applicable To

  • Resolved systemic lupus erythematosus

Excludes

  • Active systemic lupus erythematosus (M32.x)

Clinical Validation Requirements

  • Explicit documentation of resolved SLE
  • No current treatment or symptoms

Code-Specific Risks

  • Incorrectly using for active SLE

Coding Notes

  • Ensure documentation clearly states the SLE is resolved.

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Glomerular disorders in diseases classified elsewhere

N08.5*
Use with M32.1x when there is renal involvement.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Systemic lupus erythematosus, unspecified

M32.9
Use when SLE is active but unspecified regarding organ involvement.

Discoid lupus erythematosus

L93.0
Use for localized lupus without systemic involvement.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting History of Lupus to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z86.29.

Impact

Clinical: Misleading patient history., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.

Mitigation Strategy

Ensure complete documentation of disease resolution.

Impact

Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.

Mitigation Strategy

Use M32.x for active SLE cases.

Impact

Using history codes for active conditions.

Mitigation Strategy

Regular training on code selection criteria.

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 Lupus, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for History of Lupus

Use these documentation templates to ensure complete and accurate documentation for History of Lupus. These templates include all required elements for proper coding and billing.

Resolved SLE follow-up

Specialty: Rheumatology

Required Elements

  • Diagnosis date
  • Resolution date
  • Current status
  • Treatment history

Example Documentation

Patient has a history of SLE diagnosed in 2010, resolved in 2020. No current symptoms or treatment required.

Examples: Poor vs. Good Documentation

Poor Documentation Example
History of lupus.
Good Documentation Example
History of systemic lupus erythematosus (SLE), resolved in 2020, no current treatment.
Explanation
The good example specifies the type of lupus and its resolution.

Need help with ICD-10 coding for History of Lupus? Ask your questions below.

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