ICD-10 Coding for Infective Endocarditis(I33.0, I38)
Complete ICD-10-CM coding and documentation guide for Infective Endocarditis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Infective Endocarditis
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I33.0 | Acute and subacute infective endocarditis | Use when infective endocarditis is confirmed with specific organism identified. |
|
| I38 | Endocarditis, valve unspecified | Use when endocarditis is documented but the valve is not specified. |
|
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 infective endocarditis
Essential facts and insights about Infective Endocarditis
Primary ICD-10-CM Codes for infective endocarditis
Decision Criteria
clinical Criteria
- Presence of vegetations on echocardiogram
documentation Criteria
- Organism identified by blood culture
Applicable To
- Infective endocarditis of native valve
Excludes
- Endocarditis due to rheumatic fever (I01.1)
Clinical Validation Requirements
- Positive blood cultures
- Echocardiographic evidence of vegetations
Code-Specific Risks
- Incorrectly using without specifying organism
Coding Notes
- Ensure to document the specific valve and organism involved.
I38 - Endocarditis, valve unspecified
Use when endocarditis is documented but the valve is not specified.
Applicable To
- Endocarditis NOS
Excludes
- Infective endocarditis (I33.0)
Clinical Validation Requirements
- General documentation of endocarditis without valve specification
Coding Notes
This code is less specific and should be avoided if more detailed information is available.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Unspecified staphylococcus as the cause of diseases classified elsewhere
B95.8Differential 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 Infective Endocarditis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I33.0.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Use specific terms for valve and organism., Follow Duke criteria for diagnosis.
Impact
Reimbursement: Incorrect coding can lead to reduced reimbursement., Compliance: May result in non-compliance with coding guidelines., Data Quality: Affects the accuracy of clinical data.
Mitigation Strategy
Use I33.0 with an additional code for the organism.
Impact
Failure to document specific organism can lead to audit issues.
Mitigation Strategy
Ensure all blood culture results are documented.
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 Infective Endocarditis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Infective Endocarditis
Use these documentation templates to ensure complete and accurate documentation for Infective Endocarditis. These templates include all required elements for proper coding and billing.
Infective Endocarditis with Identified Organism
Specialty: CardiologyRequired Elements
- Echocardiographic findings
- Blood culture results
- Clinical signs and symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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