ICD-10 Coding for H. pylori Positive(K25.9, B96.81)
Complete ICD-10-CM coding and documentation guide for H. pylori Positive. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to H. pylori Positive
K25-K29Primary Range
Diseases of the stomach and duodenum
This range includes conditions like gastric ulcers and gastritis, which are commonly associated with H. pylori infection.
Helicobacter pylori [H. pylori] as the cause of diseases classified elsewhere
This code is used as an additional code to identify H. pylori as the causative agent of another condition.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K25.9 | Gastric ulcer, unspecified as acute or chronic, without hemorrhage or perforation | Use when a gastric ulcer is confirmed and linked to H. pylori infection. |
|
| B96.81 | Helicobacter pylori [H. pylori] as the cause of diseases classified elsewhere | Use as a secondary code to indicate H. pylori as the causative agent of another condition. |
|
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 H. pylori positive
Essential facts and insights about H. pylori Positive
Primary ICD-10-CM Codes for hours pylori positive
Decision Criteria
clinical Criteria
- Confirmed gastric ulcer with positive H. pylori test
Applicable To
- Gastric ulcer due to H. pylori
Excludes
- Gastric ulcer with hemorrhage (K25.0)
Clinical Validation Requirements
- Endoscopic findings
- Biopsy results confirming H. pylori
Code-Specific Risks
- Incorrect sequencing with B96.81
Coding Notes
- Ensure documentation explicitly links the ulcer to H. pylori.
B96.81 - Helicobacter pylori [H. pylori] as the cause of diseases classified elsewhere
Use as a secondary code to indicate H. pylori as the causative agent of another condition.
Applicable To
- H. pylori infection
Excludes
- Primary diagnosis of H. pylori without associated condition
Clinical Validation Requirements
- Positive stool antigen test
- Urea breath test results
Coding Notes
Ensure the primary condition is documented and linked to H. pylori.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Helicobacter pylori [H. pylori] as the cause of diseases classified elsewhere
B96.81Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting H. pylori Positive to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K25.9.
Impact
Clinical: Misrepresentation of patient condition, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Ensure documentation includes causal language, Verify test results are included
Impact
Reimbursement: Claims may be denied if B96.81 is used as a primary code., Compliance: Non-compliance with ICD-10 coding rules., Data Quality: Inaccurate representation of patient diagnosis.
Mitigation Strategy
Always use B96.81 as a secondary code following the primary condition code.
Impact
Using B96.81 as a primary code can lead to audit flags.
Mitigation Strategy
Educate coding staff on proper sequencing rules.
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 H. pylori Positive, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for H. pylori Positive
Use these documentation templates to ensure complete and accurate documentation for H. pylori Positive. These templates include all required elements for proper coding and billing.
Confirmed H. pylori infection with gastric ulcer
Specialty: GastroenterologyRequired Elements
- Patient symptoms
- Endoscopic findings
- Biopsy results
- Link to H. pylori
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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