ICD-10 Coding for MRSA Pneumonia(J15.212)
Complete ICD-10-CM coding and documentation guide for MRSA Pneumonia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to MRSA Pneumonia
J12-J18Primary Range
Pneumonia (including bacterial, viral, and other specified types)
This range includes codes for different types of pneumonia, with J15.212 specifically for MRSA pneumonia.
Key Information: ICD-10 code for MRSA pneumonia
Essential facts and insights about MRSA Pneumonia
Primary ICD-10-CM Code for mrsa pneumonia
Decision Criteria
clinical Criteria
- Confirmed MRSA in respiratory culture and imaging evidence of pneumonia.
Applicable To
- MRSA pneumonia
Excludes
- Pneumonia due to MSSA (J15.211)
Clinical Validation Requirements
- Confirmed MRSA in sputum culture
- Imaging showing pneumonia (e.g., consolidation on CXR)
Code-Specific Risks
- Incorrectly using B95.62 with J15.212
Coding Notes
- Ensure lab confirmation of MRSA before using this code.
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.
Pneumonia due to methicillin-susceptible Staphylococcus aureus
J15.211Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting MRSA Pneumonia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code J15.212.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Ensure specific organism and site are documented., Use templates to guide documentation.
Impact
Reimbursement: May lead to incorrect DRG assignment and reimbursement issues., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data representation of MRSA cases.
Mitigation Strategy
Do not use B95.62 when J15.212 is used as it already includes MRSA.
Impact
Risk of incorrect code usage without lab confirmation.
Mitigation Strategy
Ensure lab results confirm MRSA 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 MRSA Pneumonia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for MRSA Pneumonia
Use these documentation templates to ensure complete and accurate documentation for MRSA Pneumonia. These templates include all required elements for proper coding and billing.
Uncomplicated MRSA pneumonia
Specialty: PulmonologyRequired Elements
- Patient history
- Physical examination findings
- Lab results
- Imaging studies
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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