ICD-10 Coding for Kawasaki Disease(M30.3)
Complete ICD-10-CM coding and documentation guide for Kawasaki Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Kawasaki Disease
M30-M36Primary Range
Systemic connective tissue disorders
This range includes Kawasaki disease, which is a systemic vasculitis.
Key Information: ICD-10 code for Kawasaki disease
Essential facts and insights about Kawasaki Disease
Primary ICD-10-CM Code for kawasaki disease
Decision Criteria
clinical Criteria
- Presence of fever for ≥5 days and 4/5 principal clinical features.
documentation Criteria
- Documented echocardiogram findings of coronary artery changes.
Applicable To
- Classic Kawasaki disease
- Incomplete Kawasaki disease
Clinical Validation Requirements
- Fever for ≥5 days
- Presence of at least 4 of 5 principal clinical features
- Elevated CRP or ESR
- Coronary artery abnormalities on echocardiogram
Code-Specific Risks
- Incorrect use without meeting full diagnostic criteria
- Failure to document all required clinical features
Coding Notes
- Ensure all clinical criteria are documented before coding M30.3.
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 Kawasaki Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M30.3.
Impact
Clinical: Misdiagnosis or delayed treatment., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Use checklists for clinical criteria., Regular training on documentation standards.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Ensure all clinical features and lab results are documented.
Impact
Incomplete documentation of clinical criteria for Kawasaki disease.
Mitigation Strategy
Implement regular audits and training sessions.
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 Kawasaki Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Kawasaki Disease
Use these documentation templates to ensure complete and accurate documentation for Kawasaki Disease. These templates include all required elements for proper coding and billing.
Initial diagnosis of Kawasaki Disease
Specialty: PediatricsRequired Elements
- Fever duration
- Principal clinical features
- Laboratory findings
- Echocardiogram results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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