ICD-10 Coding for ICD-10-CM Coding(E11.22, S72.022A)
Complete ICD-10-CM coding and documentation guide for ICD-10-CM Coding. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to ICD-10-CM Coding
E10-E14Primary Range
Diabetes mellitus
This range includes codes for different types of diabetes and their complications, which are commonly encountered in clinical practice.
Injury, poisoning and certain other consequences of external causes
This range covers codes related to injuries and their management, including fractures and aftercare.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E11.22 | Type 2 diabetes mellitus with diabetic chronic kidney disease | Use when a patient has type 2 diabetes and chronic kidney disease. |
|
| S72.022A | Displaced fracture of the femoral neck, initial encounter for closed fracture | Use for initial encounter of a closed femoral neck fracture. |
|
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: What is ICD-10-CM coding?
Essential facts and insights about ICD-10-CM Coding
Primary ICD-10-CM Codes for meaning
Decision Criteria
clinical Criteria
- Presence of both diabetes and CKD
Applicable To
- Diabetes with CKD
Excludes
- Diabetes with acute kidney failure
Clinical Validation Requirements
- Diagnosis of diabetes
- Evidence of CKD (e.g., eGFR <60 mL/min/1.73 m²)
Code-Specific Risks
- Ensure CKD is documented and coded separately.
Coding Notes
- Always sequence the diabetes code before the CKD code.
S72.022A - Displaced fracture of the femoral neck, initial encounter for closed fracture
Use for initial encounter of a closed femoral neck fracture.
Applicable To
- Femoral neck fracture
Excludes
- Pathological fracture
Clinical Validation Requirements
- Radiological confirmation of fracture
Coding Notes
Ensure documentation specifies the fracture type and encounter.
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 ICD-10-CM Coding to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.22.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with coding standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Review documentation for specificity, Use coding resources to find specific codes
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Ensure the seventh character accurately reflects the encounter type (e.g., initial, subsequent, sequela).
Impact
Incorrect sequencing of diabetes and complication codes.
Mitigation Strategy
Ensure diabetes is coded first, followed by complication codes.
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 ICD-10-CM Coding, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for ICD-10-CM Coding
Use these documentation templates to ensure complete and accurate documentation for ICD-10-CM Coding. These templates include all required elements for proper coding and billing.
Diabetes with CKD
Specialty: EndocrinologyRequired Elements
- Type of diabetes
- Presence of CKD
- Stage of CKD
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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