ICD-10 Coding for Tuberculosis Testing(Z11.1, Z11.7, R76.11, R76.12)
Complete ICD-10-CM coding and documentation guide for Tuberculosis Testing. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Tuberculosis Testing
Z11-Z13Primary Range
Encounter for screening for infectious and parasitic diseases
This range includes codes for screening for tuberculosis, both active and latent.
Tuberculosis
This range includes codes for confirmed cases of tuberculosis, which may be relevant following a positive test.
Abnormal immunological findings in serum without diagnosis
This range includes codes for positive test results without a diagnosis of active disease.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z11.1 | Encounter for screening for respiratory tuberculosis | Use when screening for active TB in symptomatic patients or as part of a public health measure. |
|
| Z11.7 | Encounter for testing for latent tuberculosis infection | Use for asymptomatic patients undergoing testing for latent TB. |
|
| R76.11 | Positive tuberculin skin test without active tuberculosis | Use when TST is positive but no active TB is diagnosed. |
|
| R76.12 | Positive interferon gamma release assay without active tuberculosis | Use when IGRA is positive but no active TB is diagnosed. |
|
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 latent TB testing
Essential facts and insights about Tuberculosis Testing
Primary ICD-10-CM Codes for icd 10 for test for tuberculosis
Decision Criteria
clinical Criteria
- Patient exhibits symptoms such as prolonged cough or weight loss.
Applicable To
- Screening for active TB
Excludes
- Testing for latent TB infection
Clinical Validation Requirements
- Patient presents with symptoms suggestive of active TB
- Screening as part of a public health initiative
Code-Specific Risks
- Misuse for latent TB testing
Coding Notes
- Ensure symptoms are documented if screening for active TB.
Z11.7 - Encounter for testing for latent tuberculosis infection
Use for asymptomatic patients undergoing testing for latent TB.
Applicable To
- Testing for latent TB in asymptomatic individuals
Excludes
- Screening for active TB
Clinical Validation Requirements
- Patient is asymptomatic but at risk for latent TB
- Part of routine screening for healthcare workers or immigrants
Coding Notes
Ensure documentation specifies the type of test and result.
R76.11 - Positive tuberculin skin test without active tuberculosis
Use when TST is positive but no active TB is diagnosed.
Applicable To
- Positive TST result
Excludes
- Active tuberculosis
Clinical Validation Requirements
- TST induration ≥10mm in general population
Coding Notes
Document induration size and patient risk factors.
R76.12 - Positive interferon gamma release assay without active tuberculosis
Use when IGRA is positive but no active TB is diagnosed.
Applicable To
- Positive IGRA result
Excludes
- Active tuberculosis
Clinical Validation Requirements
- IGRA result above manufacturer cutoff
Coding Notes
Document quantitative IGRA result and patient risk factors.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Tuberculosis Testing to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z11.1.
Impact
Clinical: May lead to misinterpretation of TB status., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to insufficient documentation.
Mitigation Strategy
Use structured templates for documentation., Ensure all test results are recorded in detail.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on TB testing prevalence.
Mitigation Strategy
Use Z11.7 for latent TB testing in asymptomatic patients.
Impact
Reimbursement: Claims may be rejected due to incomplete coding., Compliance: Fails to meet coding standards., Data Quality: Incomplete data on TB screening outcomes.
Mitigation Strategy
Always pair R76.11 with Z11.7 for complete documentation.
Impact
Using Z11.1 instead of Z11.7 for latent TB testing.
Mitigation Strategy
Educate staff on correct code usage and provide decision support tools.
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 Tuberculosis Testing, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Tuberculosis Testing
Use these documentation templates to ensure complete and accurate documentation for Tuberculosis Testing. These templates include all required elements for proper coding and billing.
Routine LTBI Screening
Specialty: Primary CareRequired Elements
- Reason for testing
- Patient history
- Test performed
- Results
- Impression
- Plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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