ICD-10 Coding for Klebsiella Pneumonia(J15.0, A41.5)
Complete ICD-10-CM coding and documentation guide for Klebsiella Pneumonia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Klebsiella Pneumonia
J12-J18Primary Range
Pneumonia due to other infectious organisms
This range includes pneumonia caused by various infectious organisms, including Klebsiella pneumoniae.
Sepsis
This range includes sepsis, which may be caused by Klebsiella pneumoniae, especially when pneumonia leads to systemic infection.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| J15.0 | Pneumonia due to Klebsiella pneumoniae | Use when Klebsiella pneumoniae is confirmed as the causative organism of pneumonia. |
|
| A41.5 | Sepsis due to Klebsiella pneumoniae | Use when sepsis is confirmed to be caused by Klebsiella pneumoniae. |
|
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 Klebsiella pneumonia
Essential facts and insights about Klebsiella Pneumonia
Primary ICD-10-CM Codes for klebsiella pneumonia
Decision Criteria
clinical Criteria
- Confirmed by culture and imaging
documentation Criteria
- Explicit mention of Klebsiella pneumoniae in medical records
Applicable To
- Klebsiella pneumoniae pneumonia
Excludes
- Pneumonia due to other specified bacteria
Clinical Validation Requirements
- Sputum or blood culture confirming Klebsiella pneumoniae
- Imaging showing lobar consolidation
- Symptoms such as fever, cough, and difficulty breathing
Code-Specific Risks
- Incorrectly coding without organism confirmation
- Confusing with other Gram-negative pneumonias
Coding Notes
- Ensure documentation specifies Klebsiella pneumoniae as the causative agent.
A41.5 - Sepsis due to Klebsiella pneumoniae
Use when sepsis is confirmed to be caused by Klebsiella pneumoniae.
Applicable To
- Sepsis with Klebsiella pneumoniae as the causative organism
Excludes
- Sepsis due to other specified organisms
Clinical Validation Requirements
- Blood cultures positive for Klebsiella pneumoniae
- Clinical signs of sepsis such as fever, tachycardia, and hypotension
Coding Notes
Ensure sepsis is documented as present on admission if applicable.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Klebsiella pneumoniae as the cause of diseases classified elsewhere
B96.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Klebsiella Pneumonia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code J15.0.
Impact
Clinical: Leads to inaccurate diagnosis and treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.
Mitigation Strategy
Verify culture results before finalizing diagnosis, Educate staff on documentation standards
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Ensure culture results confirm Klebsiella pneumoniae before coding.
Impact
Risk of coding without confirmed organism.
Mitigation Strategy
Implement checks for culture results before coding.
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 Klebsiella Pneumonia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Klebsiella Pneumonia
Use these documentation templates to ensure complete and accurate documentation for Klebsiella Pneumonia. These templates include all required elements for proper coding and billing.
Inpatient Admission for Pneumonia
Specialty: PulmonologyRequired Elements
- Patient history
- Clinical symptoms
- Culture results
- Imaging findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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