ICD-10 Coding for History of Shingles(Z86.1)
Complete ICD-10-CM coding and documentation guide for History of Shingles. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to History of Shingles
Z86.1Primary Range
Personal history of infectious and parasitic diseases
This range includes codes for documenting a resolved history of infectious diseases, such as shingles.
Key Information: ICD-10 code for history of shingles
Essential facts and insights about History of Shingles
Primary ICD-10-CM Code for history of shingles
Decision Criteria
clinical Criteria
- Patient has no current symptoms of shingles.
documentation Criteria
- Record states 'history of shingles' or 'resolved herpes zoster'.
Applicable To
- Resolved shingles
- History of herpes zoster
Excludes
- Active shingles (B02.x)
Clinical Validation Requirements
- Provider attestation of resolved infection
- Absence of current rash or neurological symptoms
Code-Specific Risks
- Incorrectly using active shingles codes for resolved cases
Coding Notes
- Ensure documentation clearly states the condition is resolved to avoid using active codes.
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 Shingles to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z86.1.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials or audits.
Mitigation Strategy
Train staff on documentation requirements, Use templates for consistency
Impact
Reimbursement: May lead to incorrect billing and potential denials., Compliance: Could result in non-compliance with coding guidelines., Data Quality: Affects the accuracy of patient records and data analytics.
Mitigation Strategy
Ensure documentation specifies the condition is historical and resolved.
Impact
Using B02.x codes for historical cases can trigger audits.
Mitigation Strategy
Ensure documentation clearly indicates resolved 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 Shingles, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for History of Shingles
Use these documentation templates to ensure complete and accurate documentation for History of Shingles. These templates include all required elements for proper coding and billing.
Primary Care Visit for History of Shingles
Specialty: Primary CareRequired Elements
- Patient history of resolved shingles
- No current symptoms
- Date of resolution
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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