ICD-10 Coding for History of Oral Candidiasis(Z86.19, B37.0)
Complete ICD-10-CM coding and documentation guide for History of Oral Candidiasis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to History of Oral Candidiasis
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history of other infectious and parasitic diseases | Use when the patient has a history of oral candidiasis that is no longer active. |
|
| B37.0 | Candidal stomatitis | Use for active cases of oral candidiasis with current symptoms. |
|
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 oral candidiasis
Essential facts and insights about History of Oral Candidiasis
Primary ICD-10-CM Codes for history of oral candidiasis
Decision Criteria
clinical Criteria
- Patient has no current symptoms of oral candidiasis.
documentation Criteria
- Past treatment and resolution are documented.
Applicable To
- Resolved oral candidiasis
Excludes
- Active candidiasis (B37.0)
Clinical Validation Requirements
- Documented resolution of oral candidiasis
- Past treatment records indicating resolution
Code-Specific Risks
- Misclassification as active infection
Coding Notes
- Ensure documentation clearly states the condition is historical and resolved.
B37.0 - Candidal stomatitis
Use for active cases of oral candidiasis with current symptoms.
Applicable To
- Oral thrush
Excludes
- Resolved oral candidiasis (Z86.19)
Clinical Validation Requirements
- Current clinical symptoms of oral thrush
- Positive KOH smear or culture for Candida
Coding Notes
Ensure active symptoms are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting History of Oral Candidiasis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z86.19.
Impact
Clinical: Misleading patient history., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always use 'history of' in documentation for resolved conditions.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate patient history records.
Mitigation Strategy
Use Z86.19 for historical cases.
Impact
Confusion between coding for resolved vs. active conditions.
Mitigation Strategy
Ensure documentation clearly states the condition's status.
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 Oral Candidiasis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for History of Oral Candidiasis
Use these documentation templates to ensure complete and accurate documentation for History of Oral Candidiasis. These templates include all required elements for proper coding and billing.
Routine follow-up for a patient with a history of oral candidiasis.
Specialty: Primary CareRequired Elements
- Patient history
- Resolution status
- Past treatment details
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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