ICD-10 Coding for Mycobacterium avium-intracellulare infection(A31.2, A31.0)
Complete ICD-10-CM coding and documentation guide for Mycobacterium avium-intracellulare 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-intracellulare infection
A31Primary Range
Infections due to other mycobacteria
This range includes codes for infections caused by non-tuberculous mycobacteria, such as Mycobacterium avium complex.
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 when MAC involves two or more non-contiguous organs. |
|
| A31.0 | Pulmonary mycobacterial infection | Use for isolated lung involvement with radiographic evidence. |
|
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 disseminated MAC
Essential facts and insights about Mycobacterium avium-intracellulare infection
Primary ICD-10-CM Codes for mycobacterium avium intracellulare infection
Decision Criteria
clinical Criteria
- Presence of MAC in multiple organs confirmed by culture or PCR.
Applicable To
- Disseminated MAC involving multiple organs
Excludes
- Pulmonary MAC (A31.0)
Clinical Validation Requirements
- Positive blood or bone marrow cultures
- Imaging showing multi-organ involvement
Code-Specific Risks
- Confusion with pulmonary MAC if dissemination is not confirmed.
Coding Notes
- Ensure dissemination is confirmed before using A31.2.
A31.0 - Pulmonary mycobacterial infection
Use for isolated lung involvement with radiographic evidence.
Applicable To
- Pulmonary MAC
Excludes
- Disseminated MAC (A31.2)
Clinical Validation Requirements
- Two or more positive sputum cultures
- CT showing cavitary lesions
Coding Notes
Ensure documentation specifies pulmonary involvement.
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-intracellulare 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: Leads to incorrect treatment plans., Regulatory: Non-compliance with coding guidelines., Financial: Potential loss of reimbursement.
Mitigation Strategy
Verify specific MAC identification before coding., Use culture results to guide code selection.
Impact
Reimbursement: Incorrect coding can lead to improper DRG assignment., Compliance: May result in compliance issues with coding standards., Data Quality: Affects accuracy of clinical data and patient records.
Mitigation Strategy
Ensure MAC is confirmed by culture or PCR and differentiate from TB using specific tests.
Impact
Risk of coding MAC as TB due to similar clinical presentations.
Mitigation Strategy
Ensure differentiation through specific lab tests and documentation.
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-intracellulare infection, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Mycobacterium avium-intracellulare infection
Use these documentation templates to ensure complete and accurate documentation for Mycobacterium avium-intracellulare infection. These templates include all required elements for proper coding and billing.
Pulmonary MAC in a COPD patient
Specialty: PulmonologyRequired Elements
- Chief complaint
- History of present illness
- Imaging results
- Lab results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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