ICD-10 Coding for Mycoplasma Pneumonia(J15.7)
Complete ICD-10-CM coding and documentation guide for Mycoplasma Pneumonia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Mycoplasma Pneumonia
Key Information: ICD-10 code for Mycoplasma pneumonia
Essential facts and insights about Mycoplasma Pneumonia
Primary ICD-10-CM Code for mycoplasma pneumonia
Decision Criteria
clinical Criteria
- Positive PCR test for Mycoplasma pneumoniae
documentation Criteria
- Explicit mention of Mycoplasma pneumoniae in medical records
Applicable To
- Mycoplasma pneumonia
Excludes
- Pneumonia due to other specified bacteria
Clinical Validation Requirements
- Positive PCR/nucleic acid amplification test for Mycoplasma pneumoniae
- Clinical findings such as dry cough, sore throat, and lack of response to β-lactams
Code-Specific Risks
- Incorrectly using J18.9 when Mycoplasma is confirmed
Coding Notes
- Ensure documentation specifies Mycoplasma pneumoniae confirmed by lab tests.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Mycoplasma pneumoniae as the cause of diseases classified elsewhere
B96.0Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Mycoplasma Pneumonia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code J15.7.
Impact
Clinical: May lead to inappropriate treatment, Regulatory: Non-compliance with coding standards, Financial: Potential loss of reimbursement
Mitigation Strategy
Ensure lab results are included in the documentation, Verify documentation before coding
Impact
Reimbursement: Incorrect coding can lead to lower reimbursement rates., Compliance: May result in non-compliance with coding guidelines., Data Quality: Affects the accuracy of clinical data and statistics.
Mitigation Strategy
Use J15.7 when Mycoplasma pneumoniae is confirmed by lab tests.
Impact
Using unspecified codes when specific organism is confirmed
Mitigation Strategy
Regular training on documentation and coding updates
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 Mycoplasma Pneumonia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Mycoplasma Pneumonia
Use these documentation templates to ensure complete and accurate documentation for Mycoplasma Pneumonia. These templates include all required elements for proper coding and billing.
Confirmed Mycoplasma Pneumonia
Specialty: PulmonologyRequired Elements
- Patient symptoms
- Lab test results
- Radiologic findings
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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