ICD-10 Coding for Infectious Mononucleosis(B27.00, B27.09)
Complete ICD-10-CM coding and documentation guide for Infectious Mononucleosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Infectious Mononucleosis
B27Primary Range
Infectious mononucleosis
This range includes all codes related to infectious mononucleosis, specifying different etiologies and complications.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| B27.00 | Gammaherpesviral mononucleosis without complications | Use when EBV is confirmed and no complications are present. |
|
| B27.09 | Gammaherpesviral mononucleosis with other complications | Use when EBV is confirmed and complications are present. |
|
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 infectious mononucleosis
Essential facts and insights about Infectious Mononucleosis
Primary ICD-10-CM Codes for infectious mononucleosis
Decision Criteria
clinical Criteria
- EBV IgM positive and no complications
Applicable To
- Epstein-Barr virus mononucleosis without complications
Excludes
- Cytomegaloviral mononucleosis (B25.1)
Clinical Validation Requirements
- Positive EBV IgM or VCA
- Atypical lymphocytes ≥10%
Code-Specific Risks
- Incorrectly coding without lab confirmation
Coding Notes
- Ensure EBV confirmation through lab tests before coding.
B27.09 - Gammaherpesviral mononucleosis with other complications
Use when EBV is confirmed and complications are present.
Applicable To
- EBV mononucleosis with complications like hepatitis
Excludes
- Cytomegaloviral mononucleosis (B25.1)
Clinical Validation Requirements
- Positive EBV IgM or VCA
- Documented complication such as hepatitis
Coding Notes
Document all complications explicitly.
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 Infectious Mononucleosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B27.00.
Impact
Clinical: Leads to vague clinical records., Regulatory: Non-compliance with specificity requirements., Financial: Potentially lower reimbursement rates.
Mitigation Strategy
Always confirm the specific virus before coding., Use lab results to guide code selection.
Impact
Reimbursement: May lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data.
Mitigation Strategy
Ensure EBV is confirmed via lab tests before coding.
Impact
Failure to document complications can lead to audit discrepancies.
Mitigation Strategy
Thoroughly document all clinical findings and lab results.
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 Infectious Mononucleosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Infectious Mononucleosis
Use these documentation templates to ensure complete and accurate documentation for Infectious Mononucleosis. These templates include all required elements for proper coding and billing.
Pediatric Mono with Splenomegaly
Specialty: PediatricsRequired Elements
- Patient age and symptoms
- Lab confirmation of EBV
- Complications such as splenomegaly
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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