ICD-10 Coding for Mycobacterium Avium Complex Infection(A31.2, A31.0)
Complete ICD-10-CM coding and documentation guide for Mycobacterium Avium Complex Infection. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Mycobacterium Avium Complex Infection
A31Primary Range
Infections due to other mycobacteria
This range includes all infections caused by mycobacteria other than tuberculosis, including MAC.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A31.2 | Disseminated mycobacterium avium-intracellulare complex (DMAC) | Use for disseminated MAC infections, especially in immunocompromised patients such as those with HIV. |
|
| A31.0 | Pulmonary mycobacterium avium-intracellulare complex | Use for pulmonary MAC infections with specific radiographic and culture findings. |
|
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 Mycobacterium Avium Complex infection
Essential facts and insights about Mycobacterium Avium Complex Infection
Primary ICD-10-CM Codes for mycobacterium avium complex infection
Decision Criteria
clinical Criteria
- Presence of bacteremia or multi-organ involvement
Applicable To
- Disseminated MAC
- MAC bacteremia
Excludes
- Localized MAC infections
Clinical Validation Requirements
- Documented bacteremia
- Bone marrow involvement
- Multi-organ infection in immunocompromised patients
Code-Specific Risks
- Coding without evidence of dissemination
Coding Notes
- Ensure documentation specifies dissemination and organism identification.
A31.0 - Pulmonary mycobacterium avium-intracellulare complex
Use for pulmonary MAC infections with specific radiographic and culture findings.
Applicable To
- Pulmonary MAC
Excludes
- Disseminated MAC
Clinical Validation Requirements
- Chronic cough
- Bronchiectasis/nodules on CT
- Positive sputum cultures
Coding Notes
Document radiographic findings and culture results.
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 Mycobacterium Avium Complex Infection to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A31.2.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Ensure detailed documentation of infection extent.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate healthcare data.
Mitigation Strategy
Query for confirmation: 'Is the MAC infection localized or disseminated?'
Impact
Incorrect sequencing of HIV and MAC codes.
Mitigation Strategy
Educate coders on proper sequencing rules.
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 Mycobacterium Avium Complex Infection, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Mycobacterium Avium Complex Infection
Use these documentation templates to ensure complete and accurate documentation for Mycobacterium Avium Complex Infection. These templates include all required elements for proper coding and billing.
Pulmonary MAC Progress Note
Specialty: PulmonologyRequired Elements
- Assessment
- Plan
- Radiographic findings
- Culture results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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