ICD-10 Coding for Mycobacterium avium complex(A31.2)
Complete ICD-10-CM coding and documentation guide for Mycobacterium avium complex. 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
Key Information: ICD-10 code for Mycobacterium avium complex
Essential facts and insights about Mycobacterium avium complex
Primary ICD-10-CM Code for mycobacterium avium complex
Decision Criteria
clinical Criteria
- Presence of chronic respiratory symptoms and positive MAC culture
documentation Criteria
- Document lab test results confirming MAC
Applicable To
- M. avium
- M. intracellulare
- M. chimaera
Excludes
- Tuberculosis (A15-A19)
Clinical Validation Requirements
- Positive culture or PCR for MAC
- Chronic symptoms such as cough, weight loss, or fever
- Radiographic evidence of nodular bronchiectasis or cavitary lesions
Code-Specific Risks
- Incorrectly coding as tuberculosis
- Failure to document lab confirmation
Coding Notes
- Ensure lab confirmation of MAC is documented. Sequence A31.2 before any manifestation codes.
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 Mycobacterium avium complex 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 decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Always specify 'Mycobacterium avium complex' in documentation., Verify lab results before coding.
Impact
Reimbursement: Incorrect coding may lead to lower DRG reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Ensure lab results confirm MAC before coding.
Impact
Inadequate documentation of MAC can lead to audit issues.
Mitigation Strategy
Ensure all lab results and clinical symptoms are thoroughly documented.
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, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Mycobacterium avium complex
Use these documentation templates to ensure complete and accurate documentation for Mycobacterium avium complex. These templates include all required elements for proper coding and billing.
Pulmonary MAC in HIV patient
Specialty: Infectious DiseaseRequired Elements
- Patient history
- Lab results
- Radiographic findings
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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